Organ-saving Operations in Comprehensive Treatment of Lower-Ampullary Rectal Cancer

Abstract

In recent decades, in many countries of the world there has been an increase in the incidence of colorectal cancer (CRC). The annual occurrence of 50 new cases of colorectal cancer per 100,000 population determines a 5% population risk of developing the disease throughout life 1. An alarming fact is that for the 100 newly diagnosed patients with CRC, more than 70 deaths occur, of which, in the 1st year from the moment of diagnosis, about 40%. This circumstance is due to the fact that when patients first go to the doctor, advanced forms of CRC (stage III-IV) are diagnosed in 62.4% of patients. In 25-30% of patients, distant metastases are detected at the time of surgery. In recent years, there has been a tendency to expand indications for organ-preserving operations in the CRC.At the same time, it is necessary to formulate clear criteria for their implementation on the basis of a comparative analysis of long-term treatment results, the frequency of local regional relapses, the development and implementation of techniques using staplers, as well as the justification of indications for the use of combined and complex treatment programs that increase the radicalism and ablasticity of surgical interventions.