Talk by Claire Taylor
Macmillan Nurse Consultant (Colorectal Cancer), St Mark's Hospital, London
Over the last ten years, management options for individuals with locally-advanced (PRbTME- primary rectal cancer beyond TME plane) or recurrent rectal cancers have improved considerably. Traditionally, pelvic exenterative surgery involved has been described by three distinct types of operation; anterior, posterior and total pelvic exenterations. More recent procedures include an extended lateral pelvic side-wall excision (ELSiE) for a lateral recurrence and partial sacrectomy for sacral recurrences. The aim of surgical treatment is to achieve an en-bloc resection of the tumour with a clear resection margin (R0).
Patients must be carefully consented, and all potential complications discussed in detail so that they can make an informed choice about whether they wish to proceed with treatment. In addition to coping with physical challenges, such as pain and fatigue, all patients will experience emotional issues as they adjust to alterations in their body image and function. Skilled support to address their psychological, social and financial issues is needed. Input from a range of nursing specialists in pain management, nutrition, stoma care and continence will be required. Nursing care is therefore essential throughout all stages of these patients’ surgical care.
This presentation will discuss the key role nurses play in managing any potential post-operative complications, supporting patients through the transition from critical care, to ward care and discharge home.