Colorectal (Pelvic) Surgery

Introduction

The Colorectal and Pelvic Surgery Division was established 9 years ago. Its main purpose is to bring together the divisions composed of colorectal surgeons and urologists. Cooperation between these divisions contributes not only to the establishment of effective operative techniques but also to oncological consensus including consensus on the quality of life (QOL) of patients with pelvic malignancies. New surgical procedures, such as nerve-sparing, sphincter-saving, bladder-sparing, and pouch surgeries, are presently being developed to prevent postoperative dysfunction. These new approaches will undoubtedly contribute to better QOL among patients with pelvic malignancies.

Routine Activities

The Colorectal and Pelvic Surgery Division is composed of 7 consultants (5 colorectal surgeons and 2 urologists) and 6 residents. The outpatient clinic is open 5 days a week. In the previous year, more than 350 new patients with colorectal carcinomas and more than 150 new patients with other pelvic malignancies visited the Division. Moreover, treatment plans are discussed at a weekly conference on gastrointestinal malignancies and at another weekly conference on pelvic malignancies. Many treatment modalities, such as local excision with or without adjuvant chemo- or radiotherapy and other minimally invasive forms of surgery using laparoscopy, have been introduced for the treatment of patients in the early stages of cancer. Laparoscopy-assisted operations with wider lymphadenectomy of up to more than D2 are also increasingly being performed in patients with advanced colorectal carcinomas. In the past, abdominoperineal resection has been the standard surgical procedure in patients with very low rectal cancer; however, partial anal sphincter preservation surgeries such as intersphincteric resection has been performed in more than 200 patients with very low rectal tumors and has resulted in cure, preservation of anal function, and better QOL.

● N. Saito, M. Sugito ●

Table of Contents