Colorectal Cancer Surgery: principles and types

The main principles of colorectal cancer surgery and the most common options for surgery based on anatomical location of the cancer.

The majority of colorectal cancer surgeries are performed with curative intent. They aim to remove the tumour, with margins free from disease, as well as local tissues including lymph nodes. Consideration is also made to how bowel function can be preserved as close to normal post surgery.

Surgery may be used before or after chemo or radiotherapy.

Many operations are now laparoscopic (keyhole) but occasionally an open operation is required.

The aim in the majority of cases is to join the ends of bowel after the excision in what is called a primary anastomosis. Occasionally a defunctioning loop stoma is required to allow the join to heal.

Operations include - right hemicolectomy, left hemicolectomy, sigmoidectomy, high and low anterior resections, and abdominal perineal excision of the rectum and anus (APER). The choice depends on where the tumour is. The majority are performed with a primary anastomosis, with the exception of APER where the rectum is completely removed, meaning an end colostomy is required (a permanent stoma).

Other surgeries include transanal endoscopic microsurgery (TEMS) for superficial rectal tumours, and total/subtotal colectomy for polyposis.

[GPz]

Was diagnosed 4 days ago.

Thanks for posting.

[debigdogk]

Awesome teaching, even with those unnecessary comments from some viewers, there is NO doubt your videos are the BEST. God bless you for teaching and sharing ❤❤❤❤❤

[EnochBrown-sj]

Wow. A wonderful, wonderful presentation. Many thanks!!!

[cat]

This was so clear and helpful, thank 🙏 Explained it better than my professor!

[juwaneugenio]

just assisted on an Abdominal Perineal Resection the other day, surreal experience 😮

[thMBBSamc]

Smashing boss … very useful for gen medics and med students.

[frickfrackticbaby]

Love your content! Fantastic video pal

[loanna]

sigmoid tumor only required to resect sigmoid portion not left hemicolectomy?

[ryanhoyle]

Exactly what I was looking for thanks :)

[wingchingchoi]

what is the difference between TME and APR?

[tushargoel]

Why is sigmoid also removed in APER when the tumor is only in the lower part of rectum?

[nikkishy]

For most of these procedures (excluding APR), is it always the case that a defunctioning ileostomy will be added? Or is it on a case by case basis?

Thanks for your help!

[rammylove]

Is the Hartmann's procedure the same as the sigmoid colectomy?

[noll]

Neoadjuvant therapy is used before and not after !

[LucasBrink]

The term "adjuvant" and "neoadjuvant" are switched.

[sanchsai]

what about extended right hemicolectomy and transverse colectomy?

[DrAbhinavKumar]

too much lip smacking going on in the video. needs a better mic.