Towards Standardisation of Technique for En Bloc Sacrectomy for Locally Advanced and Recurrent Rectal Cancer

Treatment strategies for advanced or recurrent rectal cancer have evolved such that the ultimate surgical goal to achieve a cure is complete pathological clearance. To achieve this where the sacrum is involved, en bloc sacrectomy is the current standard of care. Sacral resection is technically challenging and has been described; however, the technique has yet to be streamlined across units. This comprehensive review aims to outline the surgical approach to en bloc sacrectomy for locally advanced or recurrent rectal cancer, with standardisation of the operative steps of the procedure and to discuss options that enhance the technique.

Automated summary

Treatment strategies for advanced or recurrent rectal cancer now aim for complete pathological clearance through en bloc sacrectomy, especially when the sacrum is involved. Although sacral resection is technically challenging and has been described, standardization of the technique across units is still lacking, requiring further discussion and improvement.