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Rectal cancer is a major killer. Most of those dying after curative surgery suffer from recurrent disease in the pelvis. Local recurrence is also the only site of failure in up to 50% of patients. A disturbing fact is that the local recurrence rate shows considerably surgeon-related variances. There is now strong evidence that optimizing surgical technique by adopting the principle of total mesorectal excision (TME) will reduce local failure rate, increase the use of sphincter-saving operations, and improve functional results. Surgeons applying this surgical principle will consistently achieve similarly low recurrence rates.
Priority setting and rationing contribute significantly to affordable and fair healthcare and clinicians play an indispensable role in these processes. This book offers practical strategies for clinicians to allocate resources fairly, to teach about it to students, and to discuss rationing more explicitly in the public arena and the doctor's office.
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First multi-year cumulation covers six years: 1965-70.
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