Published online Dec 27, 2016. doi: 10.4240/wjgs.v8.i12.770
Peer-review started: June 28, 2016
First decision: August 5, 2016
Revised: September 27, 2016
Accepted: October 22, 2016
Article in press: October 24, 2016
Published online: December 27, 2016
Core tip: During the last years, great efforts have been invested by many authors to contribute in treatment of rectal cancer recurrence without evidence of distant spreading. The most difficult surgical problem is to perform an affective radical R0 salvage resection. However, with the introduction of sacral resection, consistent improvements have been achieved in recent years, particularly when local tumor relapse occurs in the posterior part of the pelvis, from the presacral to the retrovescical spaces. However, abdominosacral resection is a complex surgical procedure affected by several postoperative complications. For this reason, these patients should be treated into dedicated and specialized institutions.