Surgical removal of lesions occurring in the sigmoid and rectosigmoid

Is the increasing role of Transanal Endoscopic Microsurgery in curation for T1 rectal cancer justified? A systematic review

“…This APR procedure, which gained acceptance largely because it was oncologically sound and successful, has led to the cure of many patients with rectal tumors. Dixon established the safety of the anterior resection in the late 1940s, but this approach was mainly limited to the treatment of upper rectal cancer until the 1970s [4]. The introduction of circular stapling devices facilitated the technical possibility of low rectal anastomosis and even coloanal anastomosis.…”

Lokale Therapieprinzipien beim Rektumkarzinom

“…1908 beschrieb Miles die abdominoperineale Rektumexstirpation [26], um Tumorkontrolle nicht nur durch Entfernung des Tumors selbst, sondern auch durch die Mitnahme des kranialen, lateralen und kaudalen Lymphabflusses anzustreben. In den 1930er und 40er Jahren beschrieben Dixon [7] und Wagenstein [36] die anteriore Resektion des tumortragenden Rektums. 1951 wies Goligher darauf hin, dass der distale Lymphabfluss limitiert ist und stellt somit die Dominanz der Rektumexstirpation infrage [10].…”

Anterior Resection for Malignant Lesions of the Upper Part of the Rectum and Lower Part of the Sigmoid

“…of retrograde spread and lateral direct extension involve the lateral efferent lymphatics accompanying the middle hiemorrhoidal vessels. Such lesions must be resected by a method which in addition to removing the spread in the pelvic mesocolon allows for resection of (1) the stalks of the middle hemorrhoidal vessels, (2) levator ani muscle with the nodes included between it and the pelvic fascia, (3) the ischiorectal fat and (4) a large part of the perianal skin. One must not apply the pessimistic aphorism that if the lymphatics or veins are involved no operation is radical enough and that if there is no spread of the disease most operations for cancer are too radical.…”