Anal Sparing Surgery: Pushing the Limits of Patient Autonomy

With fast-moving scientific and technologic advancement, surgeons in this era may face ever more complicated problems and dilemmas exacerbated by the demands of increasing patient autonomy. This chapter is designed to provide surgeons with some insights to common ethical problems in adult colorectal surgery that they are likely to encounter. We present a case of watch and wait (W&W) strategy versus radical surgery and local excision for rectal cancer with complete clinical response (cCR) after neoadjuvant therapy. It illustrates some of these ethical issues and demonstrates a method for approaching the issue and finding rational solutions in a more evidence-based pattern.