Clinical Surgical Oncology (Sep 2024)

Chinese expert consensus on the pelvic exenteration for primary rectal cancer beyond total mesorectal excision planes and locally recurrent rectal cancer

  • Meng Zhuang,
  • Yingchao Wu,
  • Bin Tang,
  • Jian Zhang,
  • Tenghui Ma,
  • Xicheng Wang,
  • Yuan Tang,
  • Yong Wu,
  • Xin Wang,
  • Xishan Wang,
  • Jianqiang Tang,
  • Wang Xishan,
  • Wang Xin,
  • Yu Xiangyang,
  • Ma Tenghui,
  • Wang Quan,
  • Wang Gangcheng,
  • Wang Ziqiang,
  • Wang Zhigang,
  • Wang Guiyu,
  • Wang Gui Ying,
  • Wang Xicheng,
  • Deng Haijun,
  • Bai Wenpei,
  • Feng Bo,
  • Bi Xiaogang,
  • Zhu Yuping,
  • Zheng Liu,
  • Liu Haiyi,
  • Liu Chao,
  • Liu Qian,
  • Tang Jianqiang,
  • Xu Jianmin,
  • Sun Yi,
  • Sun Yue Ming,
  • Du Binbin,
  • Li Xinxiang,
  • Li Zhengrong,
  • Li Jun,
  • Li Xue Song,
  • Li Bo,
  • Yang Chun Kang,
  • Wu Xiaojian,
  • Wu Bin,
  • Qiu Jianguang,
  • Tong Weihua,
  • Zhang Wei,
  • Zhang Jian,
  • Chen Yinggang,
  • Wu Aiwen,
  • Wu Yingchao,
  • Wu Yong,
  • Lin Jianjiang,
  • Ji Gang,
  • Xiang Jianbin,
  • Hu Gang,
  • Yao Hongwei,
  • Yuan Weitang,
  • Peng Guo,
  • Tang Yuan,
  • Huang Ping,
  • Ying Huang,
  • Wen Bing,
  • Xie Zhongshi,
  • Zhuang Meng

Journal volume & issue
Vol. 3, no. 3
p. 100053

Abstract

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Pelvic exenteration is often required for primary rectal cancer beyond total mesorectal excision (PRC-bTME) and locally recurrent rectal cancer (LRRC). Some patients with radical resection can achieve long-term survival, but they need to face risks, such as huge surgical trauma, serious perioperative complications, permanent loss of organ function and decline in quality of life. Preoperative evaluation of PRC-bTME and LRRC should emphasize multidisciplinary collaboration and develop individualized diagnosis and treatment strategies. The principles of function preservation and risk-benefit balance in surgery oncology should be followed, and R0 resection should be emphasized. Perioperative complications, surgical trauma and organ function loss should be minimized to achieve the best quality control and balance point. This consensus was formulated by the Colorectal Cancer Committee of the Chinese Medical Doctor Association and the Gastrointestinal Surgery Committee of China International Exchange and Promotive Association for Medical and Health Care. The draft was formed based on the summary of domestic and foreign research progress and expert experience. After discussion, review and modification by experts, an anonymous voting was conducted for each major opinion, and in-depth verification was carried out according to the principles of evidence-based medicine. Finally, the Chinese expert consensus on the pelvic exenteration with primary rectal cancer beyond total mesorectal excision planes and locally recurrent rectal cancer (2023 edition) was formed. This consensus mainly summarizes the indications and contraindications of pelvic exenteration (PE) for PRC-bTME and LRRC, preoperative diagnosis and evaluation, perioperative treatment, as well as the resection scope, surgical methods, reconstruction of related organs, safety and complications of PE, postoperative follow-up and other issues, in order to provide guidance for PE in patients with PRC-bTME and LRRC.

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