Surgery for colorectal cancer

Sina Dorudi, Robert JC Steele, Colin S McArdle

    Research output: Contribution to journalArticle

    27 Citations (Scopus)

    Abstract

    Colorectal cancer remains the second commonest cause of cancer death in North America and Western Europe. Surgery remains the mainstay of treatment. The aim of surgery should be to achieve cure and to avoid locoregional recurrence. The fixity of the primary tumour determines resectability, and the extent of spread determines ultimate survival. Patients with rectal cancer present a particular problem. There is good evidence that lower local recurrence rates may be achieved both by improvements in surgical technique and the use of adjuvant radiotherapy. The importance of adequate treatment of the circumferential tumour margin cannot be over-emphasised; meticulous attention is required to ensure an adequate circumferential excision. The lowest incidences of locoregional recurrence are reported by surgeons who perform total mesorectal excision. Anorectal function, sexual and urinary dysfunction may occur after rectal excision. Both postoperative and pre-operative radiotherapy can reduce the incidence of local recurrence. However, in view of the low recurrence rates obtained with TME alone, the role of adjuvant radiotherapy requires further evaluation. Several aspects of the surgical management of colorectal cancer, for example, the role of transanal local excision of selected rectal cancers and laparoscopic surgery, the management of obstructed cases and the role of follow-up remain to be defined clearly.
    Original languageEnglish
    Pages (from-to)101-118
    Number of pages18
    JournalBritish Medical Bulletin
    Volume64
    Issue number1
    DOIs
    Publication statusPublished - Dec 2002

    Keywords

    • Aged
    • Colorectal Neoplasms
    • Humans
    • Liver Neoplasms
    • Magnetic Resonance Imaging
    • Middle Aged
    • Neoplasm Recurrence, Local
    • Neoplasm Staging
    • Patient Selection
    • Prognosis
    • Radiotherapy, Adjuvant
    • Rectal Neoplasms
    • Survival Rate
    • Tomography, X-Ray Computed

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