2 Indications and current treatments

2 Indications and current treatments

2.1 Transanal total mesorectal excision (TaTME) can be used to treat malignant or benign disease of the rectum.

2.2 The incidence of rectal cancer rises sharply with age. Symptoms include rectal bleeding and change in bowel habit, although the early stages may be asymptomatic. Treatment of rectal cancer depends on its stage. Surgery is the main treatment modality for patients with locally confined disease. It involves resection of the affected part of the rectum, with or without preservation of the anus (and formation of a colostomy when preservation of the anus is not technically possible). Adjunctive radiotherapy and chemotherapy may also be used to reduce the risk of local recurrence and prevent metastatic disease.

2.3 Benign conditions that may lead to the need for resection of the rectum include ulcerative colitis and Crohn's disease. Both are chronic conditions, characterised by periods of clinical relapse and remission. Treatment depends on the severity and extent of the disease and is aimed at reducing the frequency and severity of recurrences. Drug therapy, including corticosteroids and immunosuppressive agents (such as azathioprine), usually controls the disease adequately. For more severe cases, treatment with a monoclonal antibody (such as infliximab) may be considered. Surgical removal of the affected areas may be necessary for severe cases that do not respond to medical treatment.

  • National Institute for Health and Care Excellence (NICE)