Towards Standardisation of Technique for En Bloc Sacrectomy for Locally Advanced and Recurrent Rectal Cancer

Ailín C Rogers; John T Jenkins; Shahnawaz Rasheed; George Malietzis; Elaine M Burns; Christos Kontovounisios; Paris P Tekkis

doi:10.3390/jcm10214921

Towards Standardisation of Technique for En Bloc Sacrectomy for Locally Advanced and Recurrent Rectal Cancer

J Clin Med. 2021 Oct 25;10(21):4921. doi: 10.3390/jcm10214921.

Authors

Ailín C Rogers^{1

2

3}, John T Jenkins⁴, Shahnawaz Rasheed¹, George Malietzis^{1

5}, Elaine M Burns⁴, Christos Kontovounisios^{1

5

6}, Paris P Tekkis^{1

5

6}

Affiliations

¹ Department of Surgery, Royal Marsden Hospital, London SW3 6JJ, UK.
² Department of Colorectal Surgery, Mater Misericordiae University Hospital, D07 R2WY Dublin, Ireland.
³ School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland.
⁴ Department of Surgery, St. Mark's Hospital, Watford Road, Harrow HA1 3UJ, UK.
⁵ Colorectal Surgical Unit, Chelsea and Westminster Hospital, Chelsea, London SW10 9NH, UK.
⁶ Department of Surgery and Cancer, The Royal Marsden Campus, Chelsea and Westminster Hospital and Imperial College, Paddington, London SW10 9NH, UK.

Abstract

Treatment strategies for advanced or recurrent rectal cancer have evolved such that the ultimate surgical goal to achieve a cure is complete pathological clearance. To achieve this where the sacrum is involved, en bloc sacrectomy is the current standard of care. Sacral resection is technically challenging and has been described; however, the technique has yet to be streamlined across units. This comprehensive review aims to outline the surgical approach to en bloc sacrectomy for locally advanced or recurrent rectal cancer, with standardisation of the operative steps of the procedure and to discuss options that enhance the technique.

Keywords: advanced rectal cancer; en bloc; recurrent colorectal cancer; sacrectomy.

Publication types

Review