الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The technique of APR has changed substantially in the past century, with significant improvements in early postoperative outcome,long-term oncologic outcome, and quality of life. APR, according to the principles of TME, has provided for substantial improvement in local failure and overall survival rates. In addition, when oncologically appropriate, APR performed with ANP can contribute to substantial improvements in postoperative genitourinary and sexual function.Experience with laparoscopic-assisted APR suggests that this procedure may provide for decreased postoperative morbidity, and appears safe and effective for rectal cancer resection. However, large, prospective studies are needed before definitive conclusions can be drawn.Clear advantages have been demonstrated for the laparoscopic approach in term of decreased intra-operative blood loss, faster post operative recovery & return of bowel function, decreased pain, decreased hospital stay and improved quality of life. Questions still exist about the cost and longer operating times of laparoscopic procedures. Many studies have shown that laparoscopy has a less overall cost and operating time decreases significantly with experience.For laparoscopic rectal resection in malignancy, laparoscopy is able to help surgeons reach free excision margins and harvest as many lymph nodes as would conventional surgery do.- 119 -Summary & Conclusion Despite the increasing acceptability of minimally invasive methods for the management of the malignant rectal pathologies, laparoscopic rectal resection remains a prohibitively difficult technique to master.Numerous technological innovations have been introduced into the market in an effort to decrease the steep learning curve associated with laparoscopic rectal surgery.