[Staged resection in rectal carcinoma]

Abstract

Introduction: The objectives of surgical treatment of rectal cancer are radical tumor excision, low morbidity and adequate functional outcome. The technique of total mesorectal excision (TME) has reduced the rate of local recurrences and led to an increase of ultra-low colorectal and coloanal anastomoses, which have a higher risk for anastomotic leakage.

Methods: Advantages, disadvantages and consequences of staged resection for rectal cancer are discussed on the basis of international literature and our own results.

Results: There are few stringent criteria for the use of diverting stomas. The decision for staged resection is often influenced by the personal experience of the surgeon.

Conclusions: The occurrence of anastomotic leaks cannot be prevented by diverting ostomies, but the usually irreversible consequences regarding survival and functional outcome can be minimized.