Colorectal Cancer: New Surgical Techniques

Colorectal Cancer: New Surgical Techniques

By Dr. Christoforos Efthymiadis, MSc, FEBS, General Surgeon Specializing in Advanced Laparoscopic and Robotic Surgery


Colorectal cancer is the third most common malignant tumor after breast and lung cancer and is the second most common cause of cancer death. It occurs in men with a slightly higher incidence and 75% of the patients diagnosed are 65 years of age or older.

The large intestine is the final part of the digestive tract that extends from the mouth to the anus. Its length is about one and a half to two meters and mainly serves the role of storage of by-products of digestion but also water and electrolyte absorption. Anatomically it is divided into the colon, the rectum and anal canal.

As in all other organs of the body, the large intestine has malignant neoplasms with the vast majority being adenocarcinoma.

How is it treated?

The treatment of colorectal cancer is multifactorial but surgery plays a central role. The patient must undergo surgery to remove the malignant tumor along with a portion of the intestine as well as all the lymph nodes corresponding to the area. The excluded portion will be sent for histopathological examination where the stage of the disease will be determined. Based on the staging of the disease, it is decided whether the patient is to undergo adjuvant chemotherapy and / or radiation.

The introduction of laparoscopic and robotic surgery in the treatment of colorectal cancer patient has dramatically improved the results as it provides:

  • Easier identification of noble elements due to magnification
  • Less post-operative pain
  • Faster mobilization of the patient and return to his / her daily life
  • Oncological results completely comparable to open surgery
  • Better cosmetic result
  • Treatment of metastases

In the large intestine, the presence of metastases, that is, the spread of the tumor to other organs, in particular the liver and lungs, is an indication of advanced disease. Advances in both medical science and technology now provide many possibilities for the treatment of metastatic disease such as:

  • Surgical resection of metastases
  • Ablation (burning) of metastases (RF)
  • Embolism
  • Chemo-embolism
  • Chemotherapy

Monitoring - Outcome

After initial treatment all patients should be closely monitored. The monitoring plan in the first period is very intense and frequent and the intervals can grow over time. Postoperative follow-up of these patients includes:

  • Computed Tomography
  • Colonoscopy
  • Screening for cancer markers
  • Blood tests
  • Clinical examination

Colorectal cancer is becoming more common nowadays and is affecting a large part of the population. Implementation of prevention programs, early diagnosis and sound and scientifically documented treatment have now led to a dramatic increase in the survival of these patients, an improvement in their quality of life and, in many cases, cure.

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