Surgical treatment of locally recurrent rectal carcinoma after curative surgery is not always curative, but can provide good palliation of severe pain, bleeding, perforation, obstruction and sepsis. These procedures can be carried out with minimal mortality rates (0.8%) and can benefit from long-time survival benefits. More than 50% of patients could undergo a curative (R0) resection. This requires careful consideration of several of the most important factors: procedures must be carried out by an experienced, highvolume surgeon, with considerable expertise in this field; patients together with the type of salvage procedure must be selected carefully, considering all the factors listed above. Procedures should be carried out in high-volume hospitals.
Meticulous follow-up and early detection of recurrence are conditions for curative salvage surgery.
Advanced stages of disease may not always be a contraindication for operative treatment, providing a good surgical strategy and tactics.
A multidisciplinary approach and teamwork are ultimate conditions for success. Besides surgery, which is a dominant method of treatment, other modalities of therapy, namely hemio- and radiotherapy, should be included.
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