The Sentinel Node in Colorectal Carcinoma
May 1st 2002The role of sentinel lymph node identification has been investigated over the past decade in a variety of malignancies. It has become part of standard care for melanoma. Its role in breast cancer is evolving, but with the completion of two large randomized clinical trials, it will probably be added to the surgical armamentarium for the management of most breast cancers. Studies have been proposed or are under way to evaluate sentinel node mapping in head and neck cancer, penile and vulvar cancer, and gastrointestinal cancers.
Sphincter-Preserving Operations for Rectal Cancer
November 1st 1996Until 1980, the greatest advances in the management of rectal cancer were technical ones. Whereas in the past most patients with rectal cancer underwent an abdominoperineal resection, it became possible in the 1980s to maintain intestinal continuity in the majority of patients with a low anterior resection and colorectal anastomosis and, more recently, with a low anterio resection and coloanal anastomosis. These advances were due, in part, to the development of stapling devices, which allowed surgeons to perform anastomoses that were technically difficult to perform by hand. More importantly, it became clear that in tumors identified at a relatively early stage, retrograde tumor spread was uncommon, and a 2-cm distal margin was generally adequate.