الفهرس | Only 14 pages are availabe for public view |
Abstract Colorectal cancer is the third highest cause of cancer mortality. The majority of colorectal cancers begin as benign lesions in the colon called adenomatous polyps. Over a period of several years, the cells inside the polyp transform into a malignant lesion known as colorectal carcinoma. Colorectal cancer is the third most commonly diagnosed cancer in the United Kingdom after breast and lung. The ultimate goal in the treatment of rectal cancer is to maximize local control and to improve overall long-term survival. Local recurrence is a serious problem in the treatment of rectal cancer, since it causes disabling symptoms and is difficult to treat; besides, it is thought to be an important factor in overall long-term survival. After conventional surgery, a high incidence of local recurrence of up to 40% was reported. In contrast to the perineal excision, which was practiced more widely at the time, the “Miles operation” was the first resection for rectal cancer to address the high incidence of recurrence due to direct or lymphatic spread in the upward, as well as the lateral and downward, directions. The abdominoperineal resection (APR) remained extraordinarily controversial because of its early mortality and morbidity. With the introduction of the two-team approach in 1934 and of blood transfusion in Britain in 1939, the APR became the most popular method of dealing with rectal cancer. |