PERSONALIZED SURGERY FOR RECTAL TUMORS - THE PATIENTS OPINION COUNTS

In recent times there have been many important changes in the surgical management of rectal cancer. The general thrust of these changes has been towards a less invasive approach with preservation of intestinal continuity and avoidance of the psychological se quelae of a stoma, It is also becomming increasingly apparent that profound sexual and auto nomic dysfunction can be associated with abdominoperineal resection. T his paper highlights these issues and the conflict between performing an adequate oncological proceedure and reducing the incidence of posto perative psychological morbidity, It outlines the great changes there have been in surgical technique and their relevance to psychological p roblems after surgery for rectal cancer, The need for auditing psychol ogical morbidity when assessing the outcome of surgical series is emph asised, as is the importance of involving the patient in the medical d ecision making.