Current status of surgical intervention for the management of rectal cancer.

Surgery for rectal cancer has advanced greatly over the past decade. Our knowledge of total mesorectal excision has led to improved oncologic outcomes. The concept of extralevator abdomino-perineal resection shows promise for reducing recurrence rates in tumors of the low rectum and anal canal. Once popular, local excision of rectal tumors has now been shown to have largely unacceptable recurrence rates. Minimally invasive techniques of laparoscopic and robotic surgery are technically feasible, and promise decreased complications in the future. Finally, new colonoscopic and endoscopic techniques offer alternatives for those unfit for surgery.