Surgical tactics for «near-complete» rectal cancer response to neoadjuvant therapy: total mesorectumectomy or local excision?

The successes of neoadjuvant therapy for locally advanced rectal cancer, which can sometimes achieve significant tumor regression, suggests that the performance of total mesorectumectomy in certain categories of such patients may be excessive. The rapid development of minimally invasive surgical technologies designed to limit the trauma due to the intervention, reduce the risk of postoperative complications, improve the quality of life and increase the proportion of sphincter-preserving operations, initiated several studies investigating the results of local excision of irradiated tumors of rectal cancer. This review article considers the published results of such studies, the problems, and prospects of this surgical strategy. The search of scientific literature was carried out using the PubMed database.