The rectum is a six inch segment of bowel which sits in the pelvis and connects the colon to the anus. Despite its short length it is the frequent site of cancer. In 1999 there were an estimated 34,700 new rectal cancer cases and an estimated 8,700 people died of rectal cancer. Many rectal cancers can be felt by an examining finger. It is therefore recommended that everyone over the age of 40 have a digital examination as part of their annual physical examination.
Advanced rectal cancers may require the removal of the anus and the formation of a permanent colostomy. This operation is called “abdominoperineal resection of the rectum.” In recent years Colon and Rectal Surgeons have developed techniques to preserve the anus and avoid colostomy in all but the lowest rectal cancers.The pelvis is a narrow space where nerves which affect urination and sexual function lie close to the rectum. In order to minimize local recurrence of cancer without damaging sexual and urinary function the surgeon must know the preferred plane of dissection and be able to identify and preserve the nerves. Colon and Rectal surgeons have refined the techniques of “Total Mesenteric Excision” and “Autonomic Nerve Preservation” to achieve low recurrence and morbidity. These refinements have become the preferred method for removing the rectum.The surgeons of Colon and Rectal Surgeons of Long Island, PC practice Total Mesenteric Excision and Autonomic Nerve Preservation along with sphincter saving techniques in order to preserve bowel, urinary and sexual function and achieve low rates of local recurrence.
Some patients with rectal cancer may benefit from preoperative treatment with radiation and chemotherapy. Such treatment has been shown to lower rates of local recurrence and improve survival. Which patients are more likely to benefit from such treatment can be determined by examining the tumor with ultrasound.
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