MANAGEMENT OF LOW RECTAL CANCER (SPHINCTER PRESERVING SURGERY).

Аннотация:

Low rectal cancer represents one of the most challenging conditions in colorectal surgery due to its anatomical proximity to the anal sphincter complex and its significant impact on postoperative quality of life. Historically, abdominoperineal resection with permanent colostomy was considered the standard surgical approach for tumors located in the distal rectum. However, advances in oncologic principles, imaging modalities, neoadjuvant therapy, and surgical techniques have enabled sphincter-preserving surgery to become a feasible and safe option for selected patients with low rectal cancer. This thesis reviews the contemporary management strategies for low rectal cancer with a focus on sphincter-preserving procedures, including low anterior resection, intersphincteric resection, and transanal total mesorectal excision. Emphasis is placed on patient selection, oncologic safety, functional outcomes, and the role of multimodal treatment. Evidence indicates that sphincter-preserving surgery, when performed according to strict oncologic criteria, achieves comparable local control and survival outcomes while significantly improving patient quality of life.