Minimally invasive proctectomy for locally advanced rectal cancer: is less always more?
Colorectal cancer (CRC) is the 3rd most common cancer worldwide, with rectal cancer accounting for approximately 1/3 of CRC cases (1). Although there has been increasing interest in the primary treatment of rectal cancer with chemoradiotherapy in patients who experience complete clinical response, surgical management remains the gold standard treatment for curable cases and has seen significant advances in the past 4 decades (2). Total mesorectal excision (TME) which was first described by Prof. Bill Heald in 1982, saw a remarkable improvement in rates of local control for rectal cancer and paved the way for future rectal surgery (3). Advances in neoadjuvant therapies have seen a further reduction in local recurrence rates, particularly for more locally advanced tumours.