Staged resection for rectal cancer

Introduction: The objectives of surgical treatment of rectal cancer are rad ical tumor excision, low morbidity and adequate functional outcome. The tec hnique of total mesorectal excision (TME) has reduced the rate of local rec urrences and led to an increase of ultra-low colorectal and coloanal anasto moses, which have a higher risk for anastomotic leakage. Methods: Advantage s, disadvantages and consequences of staged resection for rectal cancer are discussed on the basis of international literature and our own results. Re sults: There are few stringent criteria for the use of diverting stomas. Th e decision for staged resection is often influenced by the personal experie nce of the surgeon. Conclusions: The occurrence of anastomotic leaks cannot be prevented by diverting ostomies, but the usually irreversible consequen ces regarding survival and functional outcome can be minimized.