Rectal Cancer

Symposium - Ivan Dimitrijević (Serbia) at ESCP Berlin 2017

Symposium - Julio Garcia Aguilar (USA) at ESCP Berlin 2017

Symposium - Geerard Beets (Netherlands) at ESCP Berlin 2017

Symposium chaired by Simon Bach (UK) and Eric Rullier (France)

As part of taTME month, Quentin Denost, Centre Hospitalier Universitaire Bordeaux, explores using the procedure following total ISR in female.

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Rectal cancer should be managed by a multidisciplinary team (MDT) that includes input from gastroenterology, radiology, pathology, radiation oncology, and oncology in addition to colorectal surgery. The workup of suspected rectal cancer includes digital rectal examination, rectoscopy (proctoscopy), and biopsy. Staging of the tumor requires thoracic/abdominal computed tomography, pelvic magnetic resonance imaging, and complete colonoscopy to assess local tumor growth, systemic spread, and synchronous colonic lesions. The findings should be discussed during an MDT conference to determine the optimal sequence of treatment and the timing and extent of surgical resection. Radiotherapy, which is best delivered preoperatively, reduces the risk of local recurrence and may enhance survival in high-risk patients. Concomitant chemotherapy is used to increase the effect of radiotherapy (chemosensitizing radiation). Complete resection of the rectum en bloc with the surrounding mesorectal envelope enclosing draining lymphatic tissue, called total mesorectal excision, is the gold standard to decrease the risk of local recurrence and avoid injury to adjacent pelvic structures. Rectal cancers in the middle and upper third of the rectum can be treated with sphincter-saving anterior resection and colorectal anastomosis. Cancer in the lower third of the rectum may be amenable to low anterior resection with coloanal anastomosis or require abdominoperineal excision. Tumors involving the pelvic floor or external anal sphincter are treated with extralevator abdominoperineal excision and permanent colostomy. Preoperative chemoradiotherapy may result in complete clinical and radiological response. Such patients may enter a watch-and-wait program of intensive surveillance to detect tumor regrowth. Review of the surgical specimen pathology during a postoperative MDT meeting is important to ensure treatment quality and to determine the potential need for adjuvant chemotherapy. Follow-up after treatment, to detect metachronous colorectal cancer, local recurrence, or systemic disease, should continue for 5 years. Surgery and radiotherapy have adverse effects on function of the bowel, urinary bladder, sexual organs, and gonads, which warrant attention both at the onset of treatment and during follow-up.

As part of taTME month, ESCP were delighted to hear from Manish Chand, University College London, on the outlook for taTME. 

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Symposium - Gordon Carlson at ESCP Milan 2016

Symposium - Pieter Tanis at ESCP Milan 2016

Symposium - Antonio Lacy at ESCP Milan 2016

Symposium - Antonino Spinelli at ESCP Milan 2016

Symposium - Inna Tulina at ESCP Milan 2016

Educational session - Jarno Melenhorst at ESCP Milan 2016

Educational session - Steven Wexner at ESCP Milan 2016

Educational session - Ayhan Kuzu at ESCP Milan 2016

Symposium - Frederic Ris at ESCP Milan 2016

One of the Six Best Free Papers - Milou Martens at ESCP Dublin 2015

One of the Six Best Free Papers - Muhammed Siddiqui at ESCP Dublin 2015

Educational session - Søren Laurberg at ESCP Dublin 2015

Free Paper (Functional) - Soran Gadan at ESCP Dublin 2015

Free Paper (Functional) - Son Il Tae at ESCP Dublin 2015

Free Paper (Neoplasia) - Johan Erlandsson at ESCP Dublin 2015

Free Paper (Neoplasia) - Evgeni Rybakov at ESCP Dublin 2015

Free Paper (Neoplasia) - Daniel Leonard at ESCP Dublin 2015

Free Paper (Neoplasia) - Jakob Lykke at ESCP Dublin 2015

Free Papers (Neoplasia) - Jérémie Lefevre at ESCP Dublin 2015

Free Paper (Neoplasia) - Christina Fleming at ESCP Dublin 2015

Keynote Lecture - Andrea Coratti at ESCP Dublin 2015

Japanese Visiting Fellow - Kenji Matsuda at ESCP Dublin 2015

ESCP/EAES Symposium - Andreas Zerz at ESCP Dublin 2015