Abstract
The surgical treatment of low rectal cancer has changed greatly in recent years. Intersphincteric resection (ISR) has emerged as a new option for anus-preserving surgery, and endoscopic surgery for rectal cancer has also been widely performed. A consensus on whether laparoscopic total mesorectal excision (TME) is equivalent to radical surgery through laparotomy has not been reached after some randomized, controlled, clinical trials. In recent years, a new surgical method based on a surgical assist robot and a transanal endoscopic approach (taTME) has also appeared, and it is expected to be an option that can provide better clinical results than laparoscopic surgery. Lateral lymph node dissection, which has conventionally been done in Japan, has undergone a randomized, controlled trial, and its clinical significance has been clarified. Preoperative chemoradiotherapy (CRT) in Western countries has become a standard treatment that can reduce the local recurrence rate. On the other hand, lateral lymph node dissection has also been shown to be an effective treatment method for suppressing local recurrence in the lateral region; the results became noticeable not only in Japan, but also abroad.
