Rectal Cancer: Operative Treatment Transabdominal

Anatomically, the rectum extends from the point at which the three taenia coli fuse into a single longitudinal smooth muscle layer (rectosigmoid junction) to the anal canal. However, from an oncologic perspective, it corresponds to the distal 12 cm of the large bowel measured from the anal verge. According to this definition, most of the rectum is located below the anterior peritoneal reflection. Cancers that occur proximal to this level in the average patient behave more like colon cancers and are treated accordingly. This chapter reviews the preoperative evaluation and clinical staging of patients with rectal cancer and management options based on stage of disease, highlighting a multi-disciplinary approach, careful preoperative planning, sequential multimodal therapy, and transabdominal approaches.