ABSTRACT
The surgical management of rectal cancer has evolved from a disease without any possibility of cure in the early 1700s where surgical management consisted of the palliative drainage of disease related abscesses to the present day where surgical cure is not only possible but also possible with sphincter or even organ preservation. Prof Habr-Gama's lecture describes the evolution of the surgical management of rectal cancer and the current focus on organ preservation.
Subject(s)
Organ Sparing Treatments/methods , Quality Improvement , Rectal Neoplasms/therapy , Disease Management , History, 18th Century , History, 19th Century , History, 20th Century , Humans , Organ Sparing Treatments/history , Rectal Neoplasms/mortality , Rectal Neoplasms/pathology , Survival Analysis , Treatment OutcomeABSTRACT
"Modern" rectal cancer treatment began in the 18th century. However, initial results of the pioneer surgeons were very poor. During the next several decades, significant progress was made towards the cure of rectal cancer. Improvements have included lowering mortality, reducing recurrence, and optimizing functional outcomes. This article reviews the individuals and their advancements in rectal cancer treatment. It describes the changes in the surgical approach for tumor resection, the study of the lymphatic spread of rectal cancer and the advances in sphincter preservation procedures from the era of blunt dissection until the paradigm changing revolution of total mesorectal excision.
Subject(s)
Digestive System Surgical Procedures/trends , Dissection/trends , Rectal Neoplasms/surgery , Anal Canal , Anastomosis, Surgical/methods , Anesthesia/history , Anesthesia/methods , Digestive System Surgical Procedures/history , Digestive System Surgical Procedures/methods , Dissection/history , Dissection/methods , Egypt , Europe , History, 18th Century , History, 19th Century , History, 20th Century , History, Ancient , Humans , Organ Sparing Treatments/history , Organ Sparing Treatments/methods , Rectal Neoplasms/history , Surgical Stapling/history , Surgical Stapling/methodsABSTRACT
Prosthetic breast reconstruction has evolved over the years to provide results that now mimic that of a natural breast. This is due to a variety of innovations and advancements related to mastectomy techniques, acellular dermal matrices, autologous fat grafting, and improved breast implants. The evolution of prosthetic breast reconstruction has gone full-circle and included prepectoral placement in the 1970s and 80s, partial or total subpectoral placement from 1985 to 2015, and now gradually trending back to prepectoral. There are several techniques and strategies that now allow for patients to achieve results that are superior to any time over the past 50 years. This manuscript will review the salient aspects of prosthetic breast reconstruction and how its evolution has progressed over the years.