Glossary of surgical oncology, colorectal and peritoneal disease

Abdominal CT

Computed tomography, CT scan

Basic imaging test to assess the extent of the tumour and plan surgery. It tends to underestimate carcinomatosis made up of small implants.

Diagnosis and staging

Abdominoperineal resection

Abdominoperineal excision

Operation in which the rectum, the anus and the sphincters are removed. It requires a permanent colostomy and is used when the sphincter cannot be safely preserved.

Surgery

Adjuvant treatment

Treatment given after surgery to destroy any tumour cells that may remain and to reduce the risk of relapse. It is usually chemotherapy and, in some cases, radiotherapy or targeted therapy.

Cancer treatment Go to the page ›

Anal cancer

Cancer of the anal canal

Tumour arising in the anal canal or in the skin next to the anus. It is different from rectal cancer and is often related to human papillomavirus. Initial treatment is usually based on radiotherapy combined with chemotherapy; surgery is reserved mainly for tumours that persist or come back.

Related concepts (2)

Squamous cell carcinoma

The most frequent type of anal cancer.

Salvage surgery for anal cancer

Operation that may be needed when the tumour does not disappear or returns after chemoradiotherapy.

Conditions

Anal dysplasia

Anal intraepithelial lesions

Alteration of the cells lining the anal canal. It is not yet a cancer, but some lesions can progress to one. It is mainly related to human papillomavirus and can be assessed with high-resolution anoscopy and biopsy.

Conditions

Anal fissure

Small wound or tear in the anal canal that usually produces intense pain during and after passing stool, sometimes with bright red bleeding.

Related concepts (4)

Acute anal fissure

Recently developed fissure that may heal with regulation of bowel transit and local treatment.

Chronic anal fissure

Persistent fissure usually associated with sphincter spasm and scar changes.

Botulinum toxin for anal fissure

Treatment that temporarily relaxes the anal sphincter and promotes healing.

Lateral internal sphincterotomy

Operation that reduces the pressure of the internal sphincter in a controlled way. It is reserved for selected patients after assessing the risk of continence disturbance.

Coloproctology

Anal fistula

Perianal fistula

Abnormal tract connecting an infected gland of the anal canal with the skin next to the anus. It can cause discharge, inflammation and repeated abscesses.

Related concepts (4)

Fistulotomy

Surgical laying open of the fistula tract. It is used when it can be done without compromising continence.

Seton

Thread or material placed through the fistula to keep it drained or to treat it gradually.

Complex anal fistula

Fistula that crosses a significant amount of sphincter, has several tracts, comes back after treatment or is related to Crohn's disease.

Sphincter-preserving techniques

Procedures aimed at treating the fistula while avoiding damage to the muscles responsible for continence.

Coloproctology

Anal or perianal abscess

Perianal abscess

Collection of pus caused by an infection close to the anus. It usually produces intense pain, swelling and sometimes fever. The usual treatment is to open and drain the abscess. An anal fistula may appear after an abscess.

Coloproctology

Anastomosis

Surgical join between two ends of bowel, or another conduit, after the diseased segment has been removed. When the join is not considered safe, it is protected temporarily with a stoma.

Surgery Go to the page ›

Anastomotic leak

Anastomotic dehiscence

Partial or complete failure of healing at the join made between two ends of bowel. It can allow bowel content to escape and cause infection. Depending on its severity it may require antibiotics, drainage, a stoma or a further operation.

Outcomes and prognosis Go to the page ›

Anoscopy

Brief examination of the anal canal with a small instrument that allows haemorrhoids, fissures, fistulas, lesions and tumours to be seen, and a biopsy to be taken when necessary.

Related concepts (1)

High-resolution anoscopy

Technique that magnifies and highlights possible lesions of the anal canal. It is used mainly to diagnose and monitor anal dysplasia related to human papillomavirus.

Endoscopy and screening

Bowel obstruction from colorectal cancer

Partial or complete blockage of the bowel caused by a tumour. It can produce pain, abdominal distension, vomiting and absence of stool or gas, and needs urgent assessment.

Related concepts (2)

Colonic stent

Device that can be placed endoscopically to open an obstructed area of the colon in selected patients.

Bridge to surgery

Procedure intended to relieve the obstruction first and allow planned surgery later.

Conditions

CC score

Completeness of Cytoreduction

Scale that measures how much tumour remains at the end of cytoreductive surgery: CC-0 (no visible residue), CC-1 (nodules smaller than 2.5 mm), CC-2 and CC-3 (larger residue). Achieving CC-0 or CC-1 is the single most important prognostic factor.

Surgery Read the full explanation ›

Circumferential resection margin

CRM

Distance between the tumour and the lateral edge of the rectal surgical specimen. It is an important indicator of the quality of the resection and of the risk of the tumour coming back in the pelvis.

Outcomes and prognosis

Clavien-Dindo classification

International scale that grades postoperative complications according to the treatment they require, from grade I, which needs no intervention, to grade V. It allows results to be compared between centres objectively.

Outcomes and prognosis

Colectomy

Colon resection

Operation in which part or all of the colon is removed. The segment resected depends on where the disease is located.

Related concepts (5)

Right hemicolectomy

Removal of the right colon.

Left hemicolectomy

Removal of part of the left colon.

Sigmoidectomy

Removal of the sigmoid colon. It is the most frequent planned operation when diverticulitis is treated surgically.

Segmental colectomy

Removal of one specific segment of the colon.

Total colectomy

Removal of the whole colon.

Surgery

Colonoscopy

Examination of the inside of the colon and rectum with a flexible tube fitted with a camera. It can detect tumours, polyps, inflammation or bleeding points, take biopsies and remove some lesions.

Related concepts (2)

Surveillance colonoscopy

Colonoscopy performed after treatment of a tumour, of a high-risk polyp or of certain episodes of diverticulitis.

Endoscopic polypectomy

Removal of one or more polyps during a colonoscopy.

Endoscopy and screening

Colorectal cancer

Colon and rectal cancer

Cancer arising in the colon or the rectum, generally from the cells lining their inner surface. Colon cancer and rectal cancer share some features, but their diagnosis and treatment differ in important ways.

Related concepts (6)

Colon cancer

Malignant tumour located in any segment of the colon. Surgery usually consists of removing the affected segment together with its lymph nodes.

Rectal cancer

Tumour located in the final part of the large bowel. Depending on its height and extent, treatment may combine radiotherapy, chemotherapy and surgery.

Localised colorectal cancer

Disease limited to the colon or the rectum and, in some cases, to the nearby lymph nodes.

Locally advanced colorectal cancer

Tumour that extends beyond the bowel wall, involves nearby structures or has risk features that may call for several combined treatments.

Metastatic colorectal cancer

Cancer that has spread to other organs or sites, such as the liver, the lung or the peritoneum. Some patients can receive treatment with curative intent.

Hereditary colorectal cancer

Cancer related to an inherited genetic alteration, such as Lynch syndrome or certain polyposis syndromes. It may require genetic testing and specific surveillance for the patient and their family.

Conditions Go to the page ›

Colorectal cancer screening

Programme designed to detect polyps or colorectal cancer before symptoms appear. It usually starts with a faecal occult blood test and, when the result is positive or other risk factors exist, a colonoscopy may be needed.

Endoscopy and screening

Colorectal polyp

Growth of the lining of the colon or rectum. Most polyps are benign, but some can turn into cancer over time, so they are removed and analysed when indicated.

Related concepts (2)

Adenoma

Type of polyp that can progress to colorectal cancer.

Malignant polyp

Polyp in which cancer cells are found. Further treatment depends on how it was removed and on its microscopic features.

Conditions

Complete mesocolic excision

CME

Colon cancer surgical technique that removes the colon segment together with its mesocolic envelope and the corresponding lymph nodes, following the anatomical planes.

Related concepts (2)

D3 lymphadenectomy

Removal of the central lymph nodes located at the origin of the main vessels of the affected colon segment.

Central vascular ligation

Control of the blood vessels close to their origin as part of an oncological colon resection.

Surgery

Cytoreductive surgery

Cytoreduction

Operation that removes every visible tumour implant from the abdomen, combining organ resections and peritonectomies. It is the backbone of treatment for peritoneal carcinomatosis and is usually combined with HIPEC.

Surgery Go to the page ›

Day-case surgery

Ambulatory surgery

Surgical procedure that allows the patient to return home the same day, without staying overnight. Many proctology operations can be done this way when clinical and social conditions allow it.

Care pathway

Diffusion-weighted MRI

DWI-MRI

Magnetic resonance sequence particularly sensitive to small peritoneal implants. It provides information that CT does not always detect.

Diagnosis and staging

Disease-free survival

DFS

Time that passes without signs of tumour after treatment carried out with curative intent.

Outcomes and prognosis

Diverticulitis

Diverticular disease

Inflammation of one or several diverticula of the colon. It usually causes pain in the lower left abdomen, fever and changes in bowel habit. Its severity and its treatment depend on whether complications are present.

Related concepts (12)

Diverticula

Small pouches that form in the wall of the colon, most often in the sigmoid colon.

Diverticulosis

Presence of diverticula without inflammation. It is common and many people have no symptoms.

Acute diverticulitis

Episode of inflammation of one or several diverticula that appears suddenly.

Uncomplicated diverticulitis

Episode without abscess, perforation, fistula, obstruction or peritonitis. Many selected patients can be treated as outpatients.

Complicated diverticulitis

Diverticulitis associated with an abscess, a perforation, a fistula, a stricture, an obstruction or peritonitis.

Diverticular abscess

Collection of pus around the colon produced by diverticulitis. Some abscesses need image-guided drainage.

Diverticular perforation

Rupture of the colon wall caused by inflammation. Its severity depends on whether the infection stays localised or spreads through the abdomen.

Peritonitis from diverticulitis

Inflammation or infection spread through the abdominal cavity that may require an emergency operation.

Recurrent diverticulitis

Occurrence of several episodes of diverticulitis over time.

Persistent symptoms after diverticulitis

Abdominal pain, bowel disturbance or limitation of daily life that continue after the acute episode has settled. They need specialist assessment to confirm the cause.

Elective surgery for diverticulitis

Planned operation to remove the affected colon segment. It may be considered because of complications, recurrent episodes or persistent symptoms that impair quality of life. The indication is individualised.

Emergency surgery for diverticulitis

Operation that may be needed in the face of a perforation, peritonitis, an obstruction or an infection that cannot be safely controlled by other means.

Conditions

EPIC

Early Postoperative Intraperitoneal Chemotherapy

Intraperitoneal chemotherapy delivered through a catheter during the first days after surgery, without heat. It is used in selected cases, far less often than HIPEC.

Intraperitoneal therapies

ERAS

Enhanced Recovery After Surgery

Protocol of perioperative care (nutrition, early mobilisation, pain control without excess opioids) that shortens hospital stay and reduces complications after major abdominal surgery.

Perioperative care

Faecal incontinence

Anal incontinence

Involuntary loss of gas or stool. It may be related to sphincter injuries, nerve disorders, childbirth, previous surgery, rectal prolapse or other bowel conditions.

Related concepts (4)

Endoanal ultrasound

Imaging test that shows the shape and integrity of the anal sphincters.

Anorectal manometry

Study that measures the pressures, sensation and coordination of the anus and rectum.

Pelvic floor rehabilitation

Exercises and techniques aimed at improving strength, coordination and continence control.

Sacral neuromodulation

Treatment that stimulates the sacral nerves with electrical impulses to improve continence in selected patients.

Pelvic floor

Flexible sigmoidoscopy

Rectosigmoidoscopy

Examination of the rectum and the distal left colon with a flexible tube fitted with a camera. It can be done in the clinic and allows the lining to be seen, lesions to be detected and biopsies to be taken when necessary. It is used to assess possible tumours of the rectum or left colon and for the periodic follow-up of rectal cancer patients on a watch and wait strategy. Unlike colonoscopy, it does not examine the whole colon.

Endoscopy and screening

Functional recovery

Recovery of mobility, independence, eating and bowel function after an illness or an operation. It matters especially in older people and after colorectal or pelvic surgery.

Perioperative care

GIST

Gastrointestinal stromal tumour

Rare sarcoma of the digestive tract, with its own treatment combining surgery and targeted therapy. It can spread across the peritoneum.

Conditions Go to the page ›

Haemorrhoids

Haemorrhoidal disease

Normal vascular cushions of the anal canal that become a disease when they cause bleeding, prolapse, itching, soiling or discomfort. Anal bleeding should not automatically be attributed to haemorrhoids without proper assessment.

Related concepts (6)

Internal haemorrhoids

They arise inside the anal canal and can cause bleeding or come outside.

External haemorrhoids

They are located under the skin around the anus.

Haemorrhoidal thrombosis

Formation of a clot in an external haemorrhoid, usually producing a painful lump of sudden onset.

Haemorrhoidal prolapse

Internal haemorrhoids coming out through the anus.

Rubber band ligation

Outpatient treatment that places a small band at the base of an internal haemorrhoid to interrupt its blood supply and make it shrink.

Haemorrhoid surgery

Operation indicated when bleeding, prolapse or discomfort cannot be controlled with conservative measures or outpatient treatments.

Coloproctology

HIPEC

Hyperthermic intraperitoneal chemotherapy

Chemotherapy heated to around 42 degrees and circulated through the abdomen at the end of cytoreductive surgery, to destroy the microscopic tumour cells that surgery cannot see.

Intraperitoneal therapies Go to the page ›

Human papillomavirus

HPV

Commonly transmitted virus that can persist in the skin and mucosa of the anal and genital area. Some types are related to anal dysplasia and anal cancer, which is why they are monitored with high-resolution anoscopy and biopsy in people at higher risk.

Conditions

Immunotherapy

Treatment that acts on the immune system so that it recognises and attacks the tumour. Its role depends on the tumour type and on specific markers, such as microsatellite instability.

Cancer treatment

Inflammatory bowel disease

IBD

Group of chronic diseases in which the bowel becomes inflamed. The main ones are Crohn's disease and ulcerative colitis. Some people need surgery when complications appear or medical treatment fails to control the disease.

Related concepts (5)

Crohn's disease

Inflammatory disease that can affect any part of the digestive tract and produce strictures, abscesses or fistulas.

Ulcerative colitis

Chronic inflammatory disease affecting the colon and the rectum.

Perianal Crohn's disease

Abscesses, fistulas, ulcers or strictures of the anal area related to Crohn's disease.

Ileoanal pouch

Reservoir created from small bowel and connected to the anus after removing the colon and rectum, in order to avoid a permanent stoma in selected patients.

Pouchitis

Inflammation of the ileoanal pouch that can cause more frequent bowel movements, urgency, pain or bleeding.

Conditions

Intraoperative radiotherapy

IORT

Single dose of radiotherapy applied directly to the tumour bed during the operation, protecting the surrounding healthy tissue.

Cancer treatment

Laparotomy

Open surgery

Surgical approach through an incision in the abdominal wall. It remains the necessary route for extensive cytoreductions and multivisceral resections.

Surgery Go to the page ›

Liver metastases

Tumour deposits in the liver coming from another organ, most often the colon or rectum. Many are operable with curative intent, alone or combined with peritoneal surgery.

Conditions Go to the page ›

Liver resection

Hepatectomy

Removal of the part of the liver involved by the tumour, preserving enough healthy volume for the organ to regenerate.

Surgery Go to the page ›

Low anterior resection

LAR

Operation to remove the part of the rectum affected by a tumour and join the colon to the remaining rectum or to the anal canal, preserving the sphincter. In some patients the join is protected temporarily with an ileostomy.

Surgery

Low anterior resection syndrome

LARS

Set of bowel disturbances that can appear after rectal surgery in which the anus is preserved. It can cause frequent or fragmented bowel movements, urgency, difficulty emptying the bowel and incontinence of gas or stool. Treatment is tailored to the symptoms and may include dietary changes, medication, pelvic floor rehabilitation or transanal irrigation.

Outcomes and prognosis

Lymphadenectomy

Removal of the lymph nodes in the tumour drainage territory, with both therapeutic and staging purposes.

Surgery

Malignant ascites

Build-up of fluid in the abdominal cavity caused by tumour disease of the peritoneum. It produces distension, early satiety and breathlessness, and is one of the most frequent reasons for consultation in peritoneal carcinomatosis.

Signs and symptoms Read the full explanation ›

Microsatellites and MMR repair system

MSI, MMR

Tests performed on the tumour to see whether the cells correctly repair certain DNA errors. The results can guide hereditary testing and the choice of some treatments.

Related concepts (3)

MMR deficiency or dMMR

Alteration of the proteins responsible for repairing DNA errors.

High microsatellite instability or MSI-H

Molecular feature that may be associated with Lynch syndrome and predict the response to certain treatments, such as immunotherapy.

Lynch syndrome

Hereditary condition that increases the risk of colorectal cancer and of other tumours.

Diagnosis and staging

Minimally invasive colorectal surgery

Laparoscopic colorectal surgery

Surgery of the colon and rectum performed through small incisions, with a camera and dedicated instruments. It includes laparoscopic and robotic surgery. The approach is chosen case by case according to the disease, the anatomy and the patient's characteristics.

Related concepts (3)

Robotic colorectal surgery

Minimally invasive approach using robotic arms controlled by the surgeon, with three-dimensional vision and greater precision in narrow spaces such as the pelvis.

Transanal surgery

Group of procedures performed through the anus, without abdominal incisions or combined with an abdominal approach.

TAMIS

Transanal minimally invasive surgery used to remove selected rectal lesions while preserving the rest of the organ.

Surgery Go to the page ›

Multidisciplinary team meeting

Tumour board

Meeting in which surgeons, oncologists, radiologists, pathologists and other specialists jointly decide each patient's treatment. In complex surgical oncology it is a quality requirement, not a formality.

Diagnosis and staging Go to the page ›

Multivisceral resection

En bloc resection

En bloc removal of the colorectal tumour together with the nearby organs or structures it directly involves. The aim is a complete resection without separating the tumour from the tissues it invades.

Surgery Go to the page ›

Neoadjuvant treatment

Treatment given before surgery to shrink the tumour, treat microscopic disease and check how it responds to the drug.

Cancer treatment Read the full explanation ›

Omentectomy

Removal of the omentum, the fatty apron hanging from the stomach and the colon. It is one of the first sites where peritoneal carcinomatosis settles, so it is resected systematically.

Surgery

Oncovascular unit

Team able to resect tumours encasing major vessels and to reconstruct them, which widens operability in cases considered unresectable.

Surgery Go to the page ›

Organ preservation in rectal cancer

Rectal preservation

Set of strategies aimed at avoiding complete removal of the rectum when the location of the tumour and its response to treatment allow it without compromising oncological safety.

Related concepts (4)

Complete clinical response

Absence of detectable signs of the tumour after treatment, on examination, endoscopy and MRI.

Watch and wait

Intensive surveillance without immediate surgery in selected patients with a complete clinical response. It requires frequent checks and the option to operate if the tumour returns.

Local excision of a rectal tumour

Removal of a selected rectal lesion through the anus, preserving the rest of the rectum.

Sphincter preservation

Treatment aimed at keeping the anus and continence whenever it is safe from an oncological and functional point of view.

Cancer treatment

Overall survival

OS

Time elapsed from diagnosis or treatment until death from any cause. It is the principal measure of efficacy in oncology studies.

Outcomes and prognosis

PCI

Peritoneal Cancer Index, Sugarbaker index

Score from 0 to 39 that quantifies how much tumour there is in the abdomen and how it is distributed across thirteen regions. It is the reference for deciding whether a complete cytoreduction is achievable.

Diagnosis and staging Read the full explanation ›

Pelvic exenteration

En bloc removal of the pelvic organs involved by the tumour, with the corresponding reconstruction. It is reserved for locally advanced or recurrent tumours, in high-volume centres.

Surgery Go to the page ›

Pelvic floor

Group of muscles, nerves and tissues that support the pelvic organs and take part in continence and evacuation.

Related concepts (3)

Obstructed defaecation

Difficulty passing stool, the need to strain excessively or the sensation of not having emptied the rectum completely.

Pelvic floor dysfunction

Alteration of the strength or coordination of the pelvic floor muscles that can affect evacuation or continence.

Pelvic floor physiotherapy

Treatment with specific exercises and techniques to improve continence, coordination and evacuation.

Pelvic floor

Pelvic recurrence of colorectal cancer

Local pelvic recurrence

Return of a rectal or colon cancer within the pelvis after previous treatment. Its assessment may call for complex surgery, radiotherapy, chemotherapy or a combination of treatments.

Conditions Go to the page ›

Peritoneal carcinomatosis

Peritoneal metastases

Spread of a tumour across the membrane lining the abdomen, the peritoneum, in the form of multiple implants. It may originate in the colon, rectum, appendix, stomach, ovary, pancreas or the peritoneum itself.

Conditions Go to the page ›

Peritoneal implants

Peritoneal nodules, peritoneal seeding

Tumour deposits on the surface of the peritoneum. Their number, size and location determine the PCI and whether a complete cytoreduction is possible.

Conditions Go to the page ›

Peritoneal mesothelioma

Rare tumour that arises in the peritoneum itself. In its most common form, the reference treatment is complete cytoreduction combined with HIPEC.

Conditions Go to the page ›

Peritonectomy

Removal of the areas of peritoneum involved by the tumour. It may extend to the diaphragm, the pelvis or the paracolic gutters, depending on the map of the disease.

Surgery Go to the page ›

Peritoneum

Thin membrane lining the abdominal wall and the organs it contains. It is the starting point of peritoneal carcinomatosis and the compartment where HIPEC and PIPAC act.

Anatomy

PET-CT

Positron emission tomography

Test combining anatomical and metabolic imaging to detect active tumour foci. In peritoneal carcinomatosis it has limitations for small and mucinous implants.

Diagnosis and staging

Pilonidal sinus

Pilonidal cyst, sacrococcygeal fistula

Formation of small openings, tracts or cavities under the skin of the cleft between the buttocks, generally related to hair being drawn in. It can cause pain, inflammation, abscesses or repeated discharge.

Related concepts (2)

Minimally invasive techniques for pilonidal disease

Procedures that clean or treat the openings and tracts through small incisions, mainly in selected cases.

Bascom techniques

Procedures that remove or shift the affected area and place the scar away from the midline to help healing and lower the risk of recurrence.

Coloproctology

PIPAC

Pressurized intraperitoneal aerosol chemotherapy

Aerosolised chemotherapy delivered by laparoscopy and repeatable over several sessions. It is indicated above all when the disease is too extensive for a complete cytoreduction.

Intraperitoneal therapies Go to the page ›

Postoperative morbidity

The set of complications that may appear after surgery. In cytoreduction with HIPEC it is reported in standardised form using the Clavien-Dindo classification.

Outcomes and prognosis

Prehabilitation

Physical, nutritional and psychological preparation in the weeks before major surgery, aimed at reaching theatre in better condition and recovering sooner.

Perioperative care

Proctology

Coloproctology

Branch of colorectal surgery dealing with conditions of the anus, the anal canal, the distal rectum and the pelvic floor. It covers haemorrhoids, anal fissure, abscesses, fistulas, pilonidal disease, rectal prolapse and faecal incontinence.

Coloproctology

Pseudomyxoma peritonei

Rare disease in which the abdomen fills with mucinous material, almost always starting from a tumour of the appendix. Its reference treatment is complete cytoreduction with HIPEC.

Conditions Go to the page ›

Quality of life

The way a disease or a treatment affects a person's physical, emotional and social wellbeing. In colorectal surgery it covers pain, eating, bowel habit, continence, independence, urinary and sexual function and the ability to carry out everyday activities.

Outcomes and prognosis

R0, R1, R2 (resection)

Classification of the surgical margin: R0 no tumour at the edges, R1 microscopic involvement and R2 visible residual tumour. It differs from the CC score, which assesses the whole abdomen.

Surgery Go to the page ›

Rectal bleeding

Rectal bleeding

Passage of bright red blood through the anus, with or without stool. It may be due to haemorrhoids, a fissure, polyps, bowel inflammation or a tumour. When it appears, especially if it recurs, it should be assessed and not automatically attributed to haemorrhoids.

Signs and symptoms

Rectal prolapse

Protrusion of the rectum through the anus. It can produce a sensation of a lump, mucus, bleeding, difficulty emptying the bowel or incontinence.

Related concepts (3)

Mucosal prolapse

Protrusion of the inner or mucosal layer of the rectum only.

Full-thickness rectal prolapse

Protrusion of the entire thickness of the rectal wall.

Rectopexy

Operation that repositions and fixes the rectum in its normal position.

Pelvic floor

Rectal tenesmus

Persistent sensation of needing to pass stool even though the rectum is empty or very little is passed. It can arise from inflammation, functional disorders or rectal lesions and needs assessment if it persists.

Signs and symptoms

Rectocele

Bulging of the rectal wall towards the vagina caused by weakening of the pelvic floor tissues. It can cause difficulty passing stool, a sensation of incomplete emptying or the need to press on the vagina or perineum to help evacuation. Treatment depends on the symptoms and may include measures to regulate bowel transit, pelvic floor physiotherapy or surgery in selected cases.

Pelvic floor

Recurrence

Relapse

Reappearance of the disease after a period of control. In peritoneal carcinomatosis it may be peritoneal, distant or mixed, and it does not always rule out further surgery.

Follow-up Read the full explanation ›

Retroperitoneal sarcoma

Tumour of connective tissue origin growing in the posterior space of the abdomen. It requires en bloc surgery and teams with specific experience.

Conditions Go to the page ›

Robotic surgery

Minimally invasive surgery performed with robotic arms controlled by the surgeon, with three-dimensional vision and greater precision in narrow spaces such as the pelvis. It is used above all in rectal and colon cancer.

Surgery Go to the page ›

Salvage surgery

Rescue surgery

Operation indicated when previous treatment, surgical or oncological, has failed to control the disease or has left sequelae. It requires teams experienced in complex reconstruction.

Surgery Go to the page ›

Second opinion

Review of the diagnosis and treatment plan by a team other than the one that proposed it. It is especially relevant when a tumour has been described as inoperable.

Care pathway Go to the page ›

Staging

Process of establishing the true extent of a tumour before treating it, using imaging, tumour markers and, in peritoneal carcinomatosis, laparoscopy. A correct surgical indication depends on it.

Diagnosis and staging Go to the page ›

Staging laparoscopy

Diagnostic laparoscopy

Examination of the abdomen with a camera, through millimetre incisions, to see the true extent of peritoneal carcinomatosis and take biopsies before deciding on treatment.

Diagnosis and staging Read the full explanation ›

Stoma

Ostomy, colostomy, ileostomy

Opening of the bowel onto the abdominal wall to divert transit into a bag. It may be temporary, to protect an anastomosis while it heals, or permanent.

Surgery Read the full explanation ›

Stoma care nursing

Stoma therapy

Specialist nursing care to prepare, educate and support people who are going to have, or already have, an ileostomy or a colostomy. It includes preoperative siting, learning how to manage the stoma, choosing the appliance and follow-up of the skin and the stoma.

Care pathway Go to the page ›

Systemic chemotherapy

Drug treatment given intravenously or orally that acts throughout the body. It is complementary to, not an alternative to, therapies directed at the peritoneum.

Cancer treatment

TNM

International system that classifies tumours according to size and local invasion (T), lymph node involvement (N) and the presence of distant metastases (M).

Diagnosis and staging

Total mesorectal excision

TME

Cornerstone technique of rectal cancer surgery that removes the rectum and the tissue surrounding it, the mesorectum, within its anatomical envelope. Performing it correctly lowers the risk of the tumour coming back in the pelvis.

Surgery

Total neoadjuvant treatment

TNT

Strategy for certain rectal cancers in which all the planned chemotherapy and radiotherapy are given before surgery is decided or performed. It can increase tumour response and make organ preservation strategies possible in selected patients.

Cancer treatment Go to the page ›

Tumour markers

CEA, CA 19-9, CA 125

Substances measurable in blood that give an indication of a tumour's activity and of its response to treatment. They cannot diagnose on their own and must be interpreted alongside imaging and clinical findings.

Diagnosis and staging Read the full explanation ›