Dr. Choti on the Role of Surgery in Rectal Cancer

Michael A. Choti, MD, chief of surgery, Banner MD Anderson Cancer Center, discusses the role of surgery in the treatment of patients with rectal cancer.

Surgery is very important, says Choti, and to achieve the best outcome the procedure generally involves full removal of the rectal lymph node. Neoadjuvant therapy can sometimes make the surgery easier. Through chemotherapy or radiotherapy, shrinking the tumor preoperatively can lead to sphincter-preserving surgery so that a permanent colostomy will not be required. Patients who typically have the best outcomes are the ones with low tumors located near the anus.

Choti adds that new surgical techniques using robotics are changing the treatment landscape. Total mesorectal excision can now be performed more effectively, leading to a better reconstructive result in the adjuvant setting.