Brazilian society of surgical oncology: Guidelines for the surgical treatment of mid‐low rectal cancer

Abstract

Background: Colorectal cancer (CRC) is the third leading cause of cancer in North America, Western Europe, and Brazil, and represents an important public health problem. It is estimated that approximately 30% of all the CRC cases correspond to tumors located in the rectum, requiring complex multidisciplinary treatment. In an effort to provide surgeons who treat rectal cancer with the most current information based on the best evidence in the literature, the Brazilian Society of Surgical Oncology (SBCO) has produced the present guidelines for rectal cancer treatment that is focused on the main topics related to daily clinical practice. Objectives:The SBCO developed the present guidelines to provide recommendations on the main topics related to the treatment of mid-low rectal cancer based on current scientific evidence.Methods: Between May and June 2021, 11 experts in CRC surgery met to develop the guidelines for the treatment of mid-low rectal cancer. A total of 22 relevant topics were disseminated among the participants. The methodological quality of a final list with 221 sources was evaluated, all the evidence was examined and revised, and the treatment guideline was formulated by the 11-expert committee. To reach a final consensus, all the topics were reviewed via a videoconference meeting that was attended by all 11 of the experts. Results:The prepared guidelines contained 22 topics considered to be highly relevant in the treatment of mid-low rectal cancer, covering subjects related to the tests required for staging, surgical technique-related aspects, recommended measures to reduce surgical complications, neoadjuvant strategies, and nonoperative treatments. In addition, a checklist was proposed to summarize the important information and offer an updated tool to assist surgeons who treat rectal cancer provide the best care to their patients.

Brazilian Society of Surgical Oncology surgical standards for resectable colorectal cancer liver metastases

“…Symptomatic primary tumors (obstructive syndrome or active bleeding) may require a specific locoregional approach before systemic treatment 57,58 . In the case of obstructive rectal tumors, a diversion stoma is preferable because neoadjuvant locoregional treatment is necessary before surgical resection 59 . Primary tumors of the colon are more suitable for resection, and colonic endoluminal prostheses appear to be a feasible alternative for obstruction relief during systemic treatment 60 …”

“…57,58 In the case of obstructive rectal tumors, a diversion stoma is preferable because neoadjuvant locoregional treatment is necessary before surgical resection. 59 Primary tumors of the colon are more suitable for resection, and colonic endoluminal prostheses appear to be a feasible alternative for obstruction relief during systemic treatment. 60 The preferred approach for asymptomatic synchronic disease is upfront systemic therapy.…”

Application of the intestine diversion tube with a double-balloon without ileostomy in low rectal cancer

“…Colon and rectal cancers in men are the second most common cancers in the Southeast and Midwest. Rectal cancer is estimated to account for approximately 30% of all colorectal cancer cases, making it an important public health issue, in addition to being a cancer that requires complex and multidisciplinary treatment (13).…”

“…Our research on an intestine diversion tube began in 2010. We used a catheter as the diversion tube and inserted it into the terminal ileum through the ileocecum to divert the intestinal contents (13). This tube is mainly used in anus preservation operations of low rectal cancer and temporary enterostomy for various traumas.…”

Application Value of High-Quality Nursing in Operating Room in Rectal Cancer Operation and its Influence on Postoperative Rehabilitation

“…In recent years, the clinical incidence of the illness has increased significantly with the changes in people's living habits, dietary structure and the increase in work pressure, and the population with the disease shows a trend of younger age. 1 Radical resection of rectal cancer is a common clinical treatment for rectal cancer at present. Although surgical treatment can directly remove the lesions, improve the disease and prolong the patients' survival time, the surgical operation can cause certain trauma to the patients' body, which can easily induce physical and psychological stress reactions.…”