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Rectal Cancer Decision-Making

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Abstract

Sound surgical decision-making is essential for optimal management of rectal cancer. It requires a full assessment of the primary tumor, presence of metastases, the patients’ surgical risks, and goals of care. These surgical decisions are often complex and nuanced, and while skills and knowledge are important, it is often a surgical decision that ultimately determines patient outcomes. Most surgical decisions are made preoperatively but there are intraoperative situations where the surgeon must adapt to unforeseen conditions. In addition, preoperative staging may be inaccurate such that treatment planning must include provisions for alternative strategies should upstaging occur following pathologic review of the surgical specimen. Much like surgical skills, decision-making requires practice with continuous analysis and reflection for improvement.

By three methods we may learn wisdom: First, by reflection, which is noblest; Second, by imitation, which is easiest; and third by experience, which is the bitterest.

Confucius

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Authors and Affiliations

  1. Department of Surgery, University of Calgary, 1403 29th St. NW, Calgary, AB, Canada, T2N 2T9

    W. Donald Buie MD, MSc, FRCSC, FACS & Anthony R. MacLean M.D., F.R.C.S.C., F.A.C.S.

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  1. W. Donald Buie MD, MSc, FRCSC, FACS
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  2. Anthony R. MacLean M.D., F.R.C.S.C., F.A.C.S.
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Correspondence to W. Donald Buie MD, MSc, FRCSC, FACS .

Editor information

Editors and Affiliations

  1. Division of Colorectal Surgery, University Hospitals Case Medical Center Case Western Reserve University, Cleveland, OH, USA

    Scott R. Steele

  2. Cleveland Clinic, Cleveland, OH, USA

    Tracy L. Hull

  3. Tufts University School of Medicine, Lahey Hospital & Medical Center, Burlington, MA, USA

    Thomas E. Read

  4. Ambrose and Gladys Bowyer, Loyola University, Chicago, IL, USA

    Theodore J. Saclarides

  5. University of Texas Medical Branch at Galveston, Galveston, TX, USA

    Anthony J. Senagore

  6. Ochsner Medical Center, New Orleans, LA, USA

    Charles B. Whitlow

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Buie, W.D., MacLean, A.R. (2016). Rectal Cancer Decision-Making. In: Steele, S.R., Hull, T.L., Read, T.E., Saclarides, T.J., Senagore, A.J., Whitlow, C.B. (eds) The ASCRS Textbook of Colon and Rectal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-25970-3_32

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