Rectal cancer is a condition that requires specialized treatment, often involving treatment by non-surgeon specialists in combination with the colorectal surgeon.
Surgical techniques for rectal surgery are evolving, and removal of rectal cancers can be performed in several ways. The choice of platform can be robotic, laparoscopic, open, and even transanal such as TEMs[Transanal endoscopic microscope], TAMIS[Transanal minimal invasive surgery], and straight transanal approaches. These transanal techniques are performed in very carefully selected cases of early rectal cancer.
The staging investigations for rectal cancer are also increasingly specialised and involve MRI scans, rectal ultrasound scans, and sometimes PET scans. The interpretation of these scans is also best done by a specially trained radiologist.
Rectal ultrasound appears to be atill very useful in staging early rectal cancer whilst MRI has better use in cancers that have penetrated through the rectal wall.
PET scanning is reserved for clarifying abnormalities that are picked up by staging CAT scans that are still done to check the health of organs such as the liver and lungs.
TAMIS and TEMs
These techniques are used for removing abnormalities of the rectal wall such as polyps. They both have platforms that enable instruments to be passed through devices inserted into the anal canal that obtain a seal so that the rectum can be infated with carbon dioxide in order to cut out these abnormalities. The abnormalities can be cut out including the full thickness of the rectal wall and the resultant defect can be stitched closed.