Rectal cancer: evolution of surgical and combined treatment methods over more than 100 years of history

Introduction. This review is dedicated to the evolution of rectal cancer treatment over more than a century. Objective. To trace the main stages of development: from the first palliative interventions at the end of the 19th century to modern high-tech approaches. Materials and methods. The article is based on an analysis of a wide range of domestic and foreign sources. Results and discussion. Key historical milestones are described, including the introduction of radical surgeries (Miles' operation, anterior rectal resection with primary anastomosis), the revolutionary significance of the total mesorectal excision technique, the establishment of combined treatment with neoadjuvant therapy, and the development of minimally invasive technologies (laparoscopy, robotic surgery, transanal total mesorectal excision). Special attention is paid to the paradigm shift from maximum oncological radicalism to the pursuit of preserving patient quality of life, including sphincter-preserving operations. The article also addresses current challenges, such as low anterior resection syndrome, and outlines prospects for treatment personalization. Conclusion. The article is useful for surgical oncologists and coloproctologists.