Abstract

It is clear that rectal cancer is one of the most important of solid tumors, for more permanent "cures" are possible for this cancer compared to all other visceral malignancies added together. There is no other major malignancy in which such enormous variation can be seen in the outcome depending on the choice of the surgeon at the initial operation. The potential for better preoperative staging and analysts of the precise extent or the cancer by improved imaging offers unique hope for the control of locally advanced disease. The management of rectal cancer has particularly changed very considerable over the last twenty years. New imaging techniques have improved preoperative assessment and radiotherapy used in appropriate cases has been shown to reduce local treatment failure which is also potentially reducible by modern surgery based upon anatomical and pathological principles of loco-regional spread. The increasingly multimodality approach characterizes all successful modern rectal cancer management, however, remarkable international differences exist in attitudes to the use of chemo and radiotherapy. Thus, whilst the multidisciplinary team approach is undoubtedly here to say, it is time to revisit the essentials of oncalogic rectal cancer surgery and have a critical appraisal in current controuersies of surgical techniques.