Despite nationwide implementation of total mesorectal excision, local recurrence of rectal cancer is still occurring in 5-10% of patients and is associated with poor survival in case curative surgery is not performed Nielsen MB et al 2011. Until 2006, patients with peritoneal carcinomatosis had only palliative treatment options Iversen LH et al 2007. During a decade our department has offered highly extensive treatment regimens for primary advanced and recurrent colorectal and anal cancer as well as recurrent cervical cancer. Low morbidity and favourable long-term survival have been documented for  these extensive procedures, like pelvic exenteration Nielsen MB et al 2012 a, hemipelvectomy Nielsen MB et al 2012 b, interstitial pelvic brachytherapy Fokdal L and Christensen HK et al 2011, cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) Iversen LH 2013 aIversen LH 2013 b,  salvage surgery for anal cancer Sunesen K et al 2009, and surgery for locally recurrent rectal cancer Nielsen MB 2015. Extralevatorabdominoperineal excision is increasingly used in low rectal cancer and requires reconstruction of the pelvic floor Christensen HK 2011. In a randomised study, two types  of mesh for reconstruction are being evaluated. Quality of life is impaired for a variable time after extensive surgery for advanced and recurrent rectal cancer Thaysen HV et al 2012Thaysen HV 2013.


Henrik Kidmose Christensen, Associate Professor, Consultant Surgeon, DMSci,
Peter Christian Rasmussen, Consultant Surgeon, MD,
Mette Møller Sørensen, MD, PhD, Senior Registrar,
Mette Bak Nielsen, MD, PhD,
Lene Hjerrild Iversen, Professor, Consultant Surgeon, DMSci, PhD,
Henriette Vind Thaysen, Clinical Nurse Specialist, MHSc, PhD