The rectosigmoid problem

Surgical Oncology
Nigel D'SouzaGina Brown

Abstract

The lack of consensus over the transition point for the end of the sigmoid and beginning of the rectum is a problem for the colorectal multidisciplinary team. In this review, we survey the wide number of landmarks for the rectosigmoid junction, and describe the theoretical and evidence-based strengths and weaknesses of each one. Without a reliable definition of the rectum, sigmoid and rectal cancers will be classified inconsistently. As the treatment strategies for sigmoid and rectal cancers are radically different, incorrect tumour localisation has a substantial impact on patient management, leading to under or over treatment. Inconsistent classification will confound investigation of metastatic patterns and treatment outcomes. Now that the rectosigmoid junction has been recognised as a distinct segment of colon by the International Classification of Diseases, further heterogeneity in management and outcomes could result to the detriment of patients and research. We describe a bespoke, anatomical and reliable landmark for the rectosigmoid junction; the sigmoid take-off.

Citations

Sep 20, 2019·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·N D'SouzaG Brown
Jul 5, 2019·Journal of the National Cancer Institute·Yvonne L EaglehouseKangmin Zhu
Apr 26, 2019·Revista Española De Enfermedades Digestivas : Organo Oficial De La Sociedad Española De Patología Digestiva·Jorge Luna-Abanto
Feb 18, 2020·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·Nigel D'SouzaGina Brown
May 25, 2020·Seminars in Ultrasound, CT, and MR·Supreeta AryaTarun Pandey
Jul 22, 2021·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Thomas PeponisRocco Ricciardi
Jul 27, 2021·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Oon-Hui NgJames D Arthur
Sep 2, 2021·Physics and Imaging in Radiation Oncology·Maurice C CoxMarkus Wendling
Nov 29, 2021·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Sanne-Marije J A HazenUNKNOWN Dutch Snapshot Research Group

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