TECHNICAL CONSIDERATIONS IN THE SURGICAL-TREATMENT OF COLON AND RECTAL-CANCER

Surgery is the primary mode of therapy for colorectal cancer. Advances beyond exteriorization began to appear at the end of the nineteenth c entury. The antibiotic era brought on more advances. Dogma abounds wit h respect to the technical aspects of surgery for colon and rectal can cer and few randomized, prospective trials have been done to evaluate the importance of these techniques. Firmly established are the techniq ues of resection of lymphatic drainage of tumors, en bloc resection of invaded structures, and obtaining at least 2 cm margins of rectal can cers. Radical lymph node dissection, luminal ligation, oophorectomy, a nd the ''No-Touch Technique'' are discussed. Despite the paucity of ir refutable scientific data to support many of the described surgical te chniques, differences in outcome between surgeons suggest that techniq ue is important. There is great need for randomized, prospective trial s to evaluate the multitude of techniques described for the surgical t reatment of colorectal cancer. (C) 1994 Wiley-Liss, Inc.