Intersphincteric resection (ISR) is the ultimate anus-sparing technique for low rectal cancer and is considered an oncologically safe alternative to abdominoperineal resection. The application of the robotic approach to ISR (RISR) has been described by few specialized surgical teams with several differences regarding approach and technique. This review aims to discuss the technical aspects of RISR by evaluating point by point each surgical controversy. Moreover, a systematic review was performed to report the perioperative, oncological, and functional outcomes of RISR. Postoperative morbidities after RISR are acceptable. RISR allows adequate surgical margins and adequate oncological outcomes. RISR may result in severe bowel and genitourinary dysfunction affecting the quality of life in a portion of patients.
Citations
Citations to this article as recorded by
Rectal Eversion as an Anus-sparing Technique in Laparoscopic Low Anterior Resection With Double Stapling Anastomosis: Long-term Functional Results Servet Karagul, Serdar Senol, Oktay Karakose, Huseyin Eken, Cuneyt Kayaalp Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2025;[Epub] CrossRef
Robotic surgery versus laparoscopic surgery for rectal cancer: a comparative study on surgical safety and functional outcomes Li TengTeng, Fu HaiXiao, Fu Wei, Zhang Xuan ANZ Journal of Surgery.2025; 95(1-2): 156. CrossRef
The Review of Modified Intersphincteric Resection in the Treatment of Ultra-Low Rectal Cancer Danni Li, Xi Xiong, Pan Diao, Jitao Hu, Wenbo Niu, Guiying Wang, Baokun Li Current Treatment Options in Oncology.2025; 26(2): 84. CrossRef
Long-term functional and prognostic outcomes of robotic intersphincteric resection for treating low rectal cancer: a single-center retrospective study Yang Bo, Wang Yigao, Zheng Mingye, Jian Zhao, Yongxiang Li International Journal of Colorectal Disease.2025;[Epub] CrossRef
Comparison of laparoscopic versus robot-assisted sugery for rectal cancer after neo-adjuvant therapy: a large volume single center experience Heyuan Zhu, Jingyu Zou, Hongfeng Pan, Ying Huang, Pan Chi BMC Surgery.2025;[Epub] CrossRef
Robotic Anterior Resection for Rectosigmoid Colon Cancer Using Single-Port Access Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek Diseases of the Colon & Rectum.2024; 67(1): e1. CrossRef
Robotic surgery for bowel endometriosis: a multidisciplinary management of a complex entity G. N. Piozzi, V. Burea, R. Duhoky, S. Stefan, C. So, D. Wilby, D. Tsepov, J. S. Khan Techniques in Coloproctology.2024;[Epub] CrossRef
Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes Chungyeop Lee, In Ja Park The World Journal of Men's Health.2024; 42(2): 304. CrossRef
Robotic beyond total mesorectal excision for locally advanced rectal cancers: Perioperative and oncological outcomes from a multicentre case series Jim S. Khan, Guglielmo Niccolò Piozzi, Philippe Rouanet, Avanish Saklani, Volkan Ozben, Paul Neary, Peter Coyne, Seon Hahn Kim, Julio Garcia-Aguilar European Journal of Surgical Oncology.2024; 50(6): 108308. CrossRef
Treatment of side limb full-thickness prolapse of the side-to-end coloanal anastomosis following intersphincteric resection: a case report and review of literature Guglielmo Niccolò Piozzi, Krunal Khobragade, Seon Hui Shin, Jeong Min Choo, Seon Hahn Kim Annals of Coloproctology.2024; 40(Suppl 1): S38. CrossRef
Robotic approach to colonic resection: For some or for all patients? Sentilnathan Subramaniam, Guglielmo Niccolò Piozzi, Seon‐Hahn Kim, Jim S. Khan Colorectal Disease.2024; 26(7): 1447. CrossRef
The role of robotic-assisted surgery in the management of rectal cancer: a systematic review and meta-analysis Chenxiong Zhang, Hao Tan, Han Xu, Jiaming Ding International Journal of Surgery.2024; 110(10): 6282. CrossRef
The Impact of a Modular Robotic Total Mesorectal Excision Training Program on Perioperative and Oncological Outcomes in Robotic Rectal Cancer Surgery Samuel Stefan, Guglielmo Niccolò Piozzi, Patricia Tejedor, Christopher C.L. Liao, Anwar Ahmad, Nasir Z. Ahmad, Syed A.H. Naqvi, Richard J. Heald, Jim S. Khan Diseases of the Colon & Rectum.2024; 67(11): 1485. CrossRef
Suitable T stage for cryosurgery to spare the anus in patients with low rectal cancer Xuejun Jiang, Zujin Ji, Xinyi Lei, Cui Liu, Fangjun Yuan Cryobiology.2023; 111: 121. CrossRef
Morbidity and oncological outcomes after intersphincteric resection of the rectum for low-lying rectal cancer: experience of a single center in a lower-middle-income country Antoinette Afua Asiedua Bediako-Bowan, Narious Naalane, Jonathan C. B. Dakubo BMC Surgery.2023;[Epub] CrossRef
Robotic male and laparoscopic female sphincter-preserving total mesorectal excision of mid-low rectal cancer share similar specimen quality, complication rates and long-term oncological outcomes Vusal Aliyev, Guglielmo Niccolò Piozzi, Elnur Huseynov, Teuta Zoto Mustafayev, Vildan Kayku, Suha Goksel, Oktar Asoglu Journal of Robotic Surgery.2023; 17(4): 1637. CrossRef
International standardization and optimization group for intersphincteric resection (ISOG‐ISR): modified Delphi consensus on anatomy, definition, indication, surgical technique, specimen description and functional outcome Guglielmo Niccolò Piozzi, Krunal Khobragade, Vusal Aliyev, Oktar Asoglu, Paolo Pietro Bianchi, Vlad‐Olimpiu Butiurca, William Tzu‐Liang Chen, Ju Yong Cheong, Gyu‐Seog Choi, Andrea Coratti, Quentin Denost, Yosuke Fukunaga, Emre Gorgun, Francesco Guerra, Ma Colorectal Disease.2023; 25(9): 1896. CrossRef
International Society of University Colon and Rectal Surgeons survey of surgeons’ preference on rectal cancer treatment Audrius Dulskas, Philip F. Caushaj, Domas Grigoravicius, Liu Zheng, Richard Fortunato, Joseph W. Nunoo-Mensah, Narimantas E. Samalavicius Annals of Coloproctology.2023; 39(4): 307. CrossRef
Short-term outcomes of da Vinci SP versus Xi for colon cancer surgery: a propensity-score matching analysis of multicenter cohorts Jin-Min Jung, Young Il Kim, Yong Sik Yoon, Songsoo Yang, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu Journal of Robotic Surgery.2023; 17(6): 2911. CrossRef
Low anterior resection syndrome: is it predictable? Dong Hyun Kang Annals of Coloproctology.2023; 39(5): 373. CrossRef
Fluorescence-guided colorectal surgery: applications, clinical results, and protocols Jin-Min Jung, In Ja Park, Eun Jung Park, Gyung Mo Son Annals of Surgical Treatment and Research.2023; 105(5): 252. CrossRef
Robotic and laparoscopic sphincter-saving resections have similar peri-operative, oncological and functional outcomes in female patients with rectal cancer Vusal Aliyev, Guglielmo Niccolò Piozzi, Niyaz Shadmanov, Koray Guven, Barıs Bakır, Suha Goksel, Oktar Asoglu Updates in Surgery.2023; 75(8): 2201. CrossRef
Development of robotic surgical devices and its application in colorectal surgery Kamil Erozkan, Emre Gorgun Mini-invasive Surgery.2023;[Epub] CrossRef
Unveiling the profound advantages of total neoadjuvant therapy in rectal cancer: a trailblazing exploration Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Donghyoun Lee, Chinock Cheong Annals of Surgical Treatment and Research.2023; 105(6): 341. CrossRef
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery Hyun Gu Lee The Ewha Medical Journal.2023;[Epub] CrossRef
Surgical Techniques for Transanal Local Excision for Early Rectal Cancer Gyoung Tae Noh The Ewha Medical Journal.2023;[Epub] CrossRef
Influence of the COVID-19 Pandemic on the Treatment Patterns and Outcomes of Colorectal Cancer In Ja Park The Ewha Medical Journal.2023;[Epub] CrossRef
Advances in the Treatment of Colorectal Cancer with Peritoneal Metastases: A Focus on Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Youngbae Jeon, Eun Jung Park The Ewha Medical Journal.2023;[Epub] CrossRef
How Can We Improve the Tumor Response to Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer? Jeonghee Han The Ewha Medical Journal.2023;[Epub] CrossRef
Clinical Implication of Lateral Pelvic Lymph Node Metastasis in Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy In Ja Park The Ewha Medical Journal.2022; 45(1): 3. CrossRef
Current status of robotic surgery for colorectal cancer: A review Won Beom Jung International Journal of Gastrointestinal Intervention.2022; 11(2): 56. CrossRef
Current status and role of robotic approach in patients with low-lying rectal cancer Hyo Seon Ryu, Jin Kim Annals of Surgical Treatment and Research.2022; 103(1): 1. CrossRef
Robotic vs. laparoscopic intersphincteric resection for low rectal cancer: a case matched study reporting a median of 7-year long-term oncological and functional outcomes Vusal Aliyev, Guglielmo Niccolò Piozzi, Alisina Bulut, Koray Guven, Baris Bakir, Sezer Saglam, Suha Goksel, Oktar Asoglu Updates in Surgery.2022; 74(6): 1851. CrossRef
Efficacy of intraoperative fluorescence imaging using indocyanine green‐containing gauze in identifying the appropriate dissection layer in laparoscopic intersphincteric resection: A case report Hiroyuki Kumata, Keisuke Onishi, Tetsuro Takayama, Kengo Asami, Noriyuki Obara, Hirofumi Sugawara, Izumi Haga Clinical Case Reports.2022;[Epub] CrossRef
Robotic surgery for colorectal cancer Sung Uk Bae Journal of the Korean Medical Association.2022; 65(9): 577. CrossRef
Direction of diagnosis and treatment improvement in colorectal cancer In Ja Park Journal of the Korean Medical Association.2022; 65(9): 540. CrossRef
Current Status and Future of Robotic Surgery for Colorectal Cancer-An English Version Sung Uk Bae Journal of the Anus, Rectum and Colon.2022; 6(4): 221. CrossRef
Update on Diagnosis and Treatment of Colorectal
Cancer Chan Wook Kim The Ewha Medical Journal.2022;[Epub] CrossRef
Low Anterior Resection Syndrome: Pathophysiology, Risk Factors, and Current Management Seung Mi Yeo, Gyung Mo Son The Ewha Medical Journal.2022;[Epub] CrossRef
Is It a Refractory Disease?- Fecal Incontinence; beyond
Medication Chungyeop Lee, Jong Lyul Lee The Ewha Medical Journal.2022;[Epub] CrossRef
Robot-Assisted Colorectal Surgery Young Il Kim The Ewha Medical Journal.2022;[Epub] CrossRef
It Is a Pleasure to Announce the Issue Titled “Master Class 2021” in Annals of Coloproctology In Ja Park Annals of Coloproctology.2021; 37(6): 349. CrossRef
The genomic causes and clinical manifestations of hereditary colorectal cancer (HCRC) might be stratified into 2 groups, namely, familial (FCRC) and a limited sense of HCRC, respectively. Otherwise, FCRC is canonically classified into 2 major categories; Lynch syndrome (LS) or associated spectra and inherited polyposis syndrome. By contrast, despite an increasing body of genotypic and phenotypic traits, some FCRC cannot be clearly differentiated as definitively single type, and the situation has become more complex as additional causative genes have been discovered. This review provides an overview of HCRC, including 6 LS or associated spectra and 8 inherited polyposis syndromes, according to molecular pathogenesis. Variants and newly-identified FCRC are particularly emphasized, including MUTYH (or MYH)-associated polyposis, Muir-Torre syndrome, constitutional mismatch repair deficiency, EPCAM-associated LS, polymerase proofreading-associated polyposis, RNF43- or NTHL1-associated serrated polyposis syndrome, PTEN hamartoma tumor syndrome, and hereditary mixed polyposis syndrome. We also comment on the clinical utility of multigene panel tests, focusing on comprehensive cancer panels that include HCRC. Finally, HCRC surveillance strategies are recommended, based on revised or notable concepts underpinned by competent validation and clinical implications, and favoring major guidelines. As hereditary syndromes are mainly attributable to genomic constitutions of distinctive ancestral groups, an integrative national HCRC registry and guideline is an urgent priority.
Citations
Citations to this article as recorded by
De novo familial adenomatous polyposis with germline double heterozygosity of APC/BRCA2: a case report and literature review Tian-Qi Zhang, Ji-Dong Cai, Cong Li, Yun Xu, Ye Xu Hereditary Cancer in Clinical Practice.2025;[Epub] CrossRef
Genetic Signatures Upon Transition from Colorectal Polyps to colon Cancer Mehran Radak, Farahnoosh Khodabakhsh Ravand, Nakisa Ghamari, Hossein Fallahi Current Tissue Microenvironment Reports.2025; 6(2): 21. CrossRef
An update of the variant spectrum of the
APC
gene in Iranian familial adenomatous polyposis patients
Seyed Mohsen Mirabdolhosseini, Leili Rejali, Mohammad Yaghoob Taleghani, Hossein Sadeghi, Seyed Mohammad Hossein Kashfi, Faeghe Behboudi Farahbakhsh, Mina Golmohammadi, Pegah Larki, Nayeralsadat Fatemi, Pardis Ketabi Moghadam, Ehsan Nazemalhosseini Mojara Nucleosides, Nucleotides & Nucleic Acids.2024; 43(1): 40. CrossRef
Performance reporting design in artificial intelligence studies using image-based TNM staging and prognostic parameters in rectal cancer: a systematic review Minsung Kim, Taeyong Park, Bo Young Oh, Min Jeong Kim, Bum-Joo Cho, Il Tae Son Annals of Coloproctology.2024; 40(1): 13. CrossRef
Sebaceomas in a Muir–Torre-like Phenotype in a Patient with MUTYH-Associated Polyposis Julia Guarrera, James C. Prezzano, Kathleen A. Mannava Dermatopathology.2024; 11(1): 124. CrossRef
The genomics of sporadic and hereditary colorectal cancer ID Sadien, RJ Davies, JMD Wheeler The Annals of The Royal College of Surgeons of England.2024; 106(4): 313. CrossRef
The Molecular Genetics of Colorectal Cancer, Hereditary Colorectal Cancer Syndromes, and Early-Onset Colorectal Cancer Joceline V. Vu, Joshua Sommovilla Digestive Disease Interventions.2023; 07(01): 058. CrossRef
Reduced expression of alanyl aminopeptidase is a robust biomarker of non‐familial adenomatous polyposis and non‐hereditary nonpolyposis colorectal cancer syndrome early‐onset colorectal cancer Ye Jin Ha, Yun Jae Shin, Ka Hee Tak, Jong Lyul Park, Jeong Hwan Kim, Jong Lyul Lee, Yong Sik Yoon, Chan Wook Kim, Seon Young Kim, Jin Cheon Kim Cancer Medicine.2023; 12(8): 10091. CrossRef
Case report: POLE (P286R) mutation in a case of recurrent intestinal leakage and its treatment Dang Xiang, Gongbo Fu, Yitian Chen, Xiaoyuan Chu Frontiers in Oncology.2023;[Epub] CrossRef
Identification of a novel CNV at the APC gene in a Chinese family with familial adenomatous polyposis Juyi Li, Chengzhi He, Jing Gong, Xiufang Wang, Chao Liu, Aiping Deng, Lin Zhu Frontiers in Molecular Biosciences.2023;[Epub] CrossRef
Inflammatory Response Markers as Predictors of Colorectal Cancer Prognosis Minsung Kim, Il Tae Son, Bo Young Oh The Ewha Medical Journal.2023;[Epub] CrossRef
A Previously Unrecognized Molecular Landscape of Lynch Syndrome in the Mexican Population Alejandra Padua-Bracho, José A. Velázquez-Aragón, Verónica Fragoso-Ontiveros, Paulina María Nuñez-Martínez, María de la Luz Mejía Aguayo, Yuliana Sánchez-Contreras, Miguel Angel Ramirez-Otero, Marcela Angélica De la Fuente-Hernández, Silvia Vidal-Millán, International Journal of Molecular Sciences.2022; 23(19): 11549. CrossRef
Direction of diagnosis and treatment improvement in colorectal cancer In Ja Park Journal of the Korean Medical Association.2022; 65(9): 540. CrossRef
Molecular analyses of peritoneal metastasis from colorectal cancer Chang Hyun Kim Journal of the Korean Medical Association.2022; 65(9): 586. CrossRef
Molecular Analyses in Peritoneal Metastasis from Colorectal Cancer: A Review-An English Version Chang Hyun Kim Journal of the Anus, Rectum and Colon.2022; 6(4): 197. CrossRef
It Is a Pleasure to Announce the Issue Titled “Master Class 2021” in Annals of Coloproctology In Ja Park Annals of Coloproctology.2021; 37(6): 349. CrossRef
Original Article
Malignant disease, Rectal cancer,Prognosis and adjuvant therapy,Colorectal cancer
Purpose We aimed to evaluate the surgicopathological outcomes of lateral pelvic lymph node dissection (LPLD) and long-term oncological outcomes of selective LPLD after neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer and compare them to those of total mesorectal excision (TME) alone based on pretreatment magnetic resonance imaging (MRI).
Methods We compared the TME-alone group (2001–2009, n=102) with the TME with LPLD group (2011–2016, n=69), both groups having lateral lymph nodes (LLNs) of ≥5 mm in short axis diameter. The surgicopathological outcomes were analyzed retrospectively. Oncological outcomes were analyzed using the Kaplan-Meier method.
Results The rates of overall postoperative 30-day morbidity (42.0% vs. 26.5%, P=0.095) and urinary retention (13.7% vs. 10.1%, P=0.484) were not significantly different between the LPLD and TME-alone groups, respectively. Pathologically proven LLN metastasis was identified in 24 (34.8%) LPLD cases after nCRT. The LPLD group showed a lower 5-year local recurrence (LR) rate (27.9% vs. 4.6%, P<0.001) and better recurrence-free survival (RFS) (59.6% vs. 78.2%, P=0.008) than those of the TME-alone group, while the 5-year overall survival was not significantly different between the 2 groups (76.2% vs. 86.5%, P=0.094).
Conclusion This study suggests that LPLD is a safe and feasible procedure. The oncological outcomes suggest that selective LPLD improves LR and RFS in patients with clinically suspicious LLNs on pretreatment MRI. Considering that lateral nodal disease is not common, a multicenter large-scale study is necessary.
Citations
Citations to this article as recorded by
MRI-based scoring systems for selective lateral lymph node dissection in locally advanced low rectal cancer after neoadjuvant chemoradiotherapy Min Jeong Cho, Kyunghwa Han, Hye Jung Shin, Woong Sub Koom, Kang Young Lee, Joo Hee Kim, Joon Seok Lim European Radiology.2025;[Epub] CrossRef
Feasibility and limitations of combined treatment for lateral pelvic lymph node metastases in rectal cancer Ying-Zi Zheng, Fang-Fang Yan, Lian-Xiang Luo World Journal of Clinical Oncology.2024; 15(5): 591. CrossRef
Totally Extraperitoneal Approach for Recurrent Lateral Pelvic Lymph Nodes After Rectal Cancer Surgery Tae-Gyun Lee, Hong-Min Ahn, Hye-Rim Shin, Mi Jeong Choi, Min Hyeong Jo, Heung-Kwon Oh, Duck-Woo Kim, Sung-Bum Kang Diseases of the Colon & Rectum.2024; 67(6): e360. CrossRef
Identification of lateral pelvic nodes without metastasis in patients with rectal cancer treated with preoperative chemoradiotherapy or chemotherapy based on magnetic resonance imaging Nobuaki Hoshino, Yudai Fukui, Kohei Ueno, Koya Hida, Kazutaka Obama, Kazuhiro Sakamoto, Hirotoshi Kobayashi, Michio Itabashi, Soichiro Ishihara, Kazushige Kawai, Yoichi Ajioka Annals of Gastroenterological Surgery.2024; 8(5): 732. CrossRef
Survival analysis in rectal cancer patients after lateral lymph node dissection: Exploring the necessity of nCRT for suspected lateral lymph node metastasis Jiafei Liu, Peishi Jiang, Zhichun Zhang, Hongjie Yang, Yuanda Zhou, Peng Li, Qingsheng Zeng, Xipeng Zhang, Yi Sun Current Problems in Surgery.2024; 61(8): 101525. CrossRef
Clinical outcomes of neoadjuvant chemoradiotherapy followed by total mesorectal excision in locally advanced rectal cancer with mesorectal fascia involvement Jeong Ha Lee, Nalee Kim, Jeong Il Yu, Gyu Sang Yoo, Hee Chul Park, Woo-Yong Lee, Seong Hyeon Yun, Hee Cheol Kim, Yong Beom Cho, Jung Wook Huh, Yoon Ah Park, Jung Kyong Shin, Joon Oh Park, Seung Tae Kim, Young Suk Park, Jeeyun Lee, Won Ki Kang Radiation Oncology Journal.2024; 42(2): 130. CrossRef
Literature research on the low rectal cancer complicated with lateral pelvic lymph node metastasis Miao He, Jing Fan Asian Journal of Surgery.2024; 47(10): 4575. CrossRef
Innovációk a colorectalis sebészetben Balázs Bánky, András Fülöp, Viktória Bencze, Lóránd Lakatos, Petra Rozman, Attila Szijártó Orvosi Hetilap.2024; 165(2): 43. CrossRef
Meta-analysis of the efficacy and safety of robot-assisted comparative laparoscopic surgery in lateral lymph node dissection for rectal cancer Hao Shi, Xianhao Yi, Xin Yan, Wenjie Wu, Hui Ouyang, Chengke Ou, Xiangheng Chen Surgical Endoscopy.2024; 38(10): 5584. CrossRef
The Role of Lateral Pelvic Lymph Node Dissection in Middle and Lower Rectal Cancer (Stage II or III): A Literature Review Alexandra-Eleftheria Menni, Georgios Tzikos, Patroklos Goulas, Stylianos Apostolidis Cureus.2024;[Epub] CrossRef
Lateral pelvic lymph node positivity (LPLNP) score: predictive clinic-radiological model of lateral pelvic lymph node involvement in rectal cancer patients Petr Tsarkov, Vladimir Balaban, Harutyun Babajanyan, Abe Fingerhut, Inna Tulina, Mingze He International Journal of Colorectal Disease.2024;[Epub] CrossRef
Short-term outcomes of 47 selective laparoscopic lymph node dissection for rectal cancer: A retrospective study Xiajuan Xue, Shuijie Lin, Qunzhang Zeng, Yincong Guo Medicine.2024; 103(43): e39684. CrossRef
Fluorescence-guided colorectal surgery: applications, clinical results, and protocols Jin-Min Jung, In Ja Park, Eun Jung Park, Gyung Mo Son Annals of Surgical Treatment and Research.2023; 105(5): 252. CrossRef
Development of a Diagnostic Artificial Intelligence Tool for Lateral Lymph Node Metastasis in Advanced Rectal Cancer Kosuke Ozaki, Yusuke Kurose, Kazushige Kawai, Hirotoshi Kobayashi, Michio Itabashi, Yojiro Hashiguchi, Takuya Miura, Akio Shiomi, Tatsuya Harada, Yoichi Ajioka Diseases of the Colon & Rectum.2023; 66(12): e1246. CrossRef
Advances in the Treatment of Colorectal Cancer with Peritoneal Metastases: A Focus on Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Youngbae Jeon, Eun Jung Park The Ewha Medical Journal.2023;[Epub] CrossRef
Clinical Implication of Lateral Pelvic Lymph Node Metastasis in Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy In Ja Park The Ewha Medical Journal.2022; 45(1): 3. CrossRef
Current status and role of robotic approach in patients with low-lying rectal cancer Hyo Seon Ryu, Jin Kim Annals of Surgical Treatment and Research.2022; 103(1): 1. CrossRef
Multidisciplinary treatment strategy for early colon cancer Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim Journal of the Korean Medical Association.2022; 65(9): 558. CrossRef
Robotic surgery for colorectal cancer Sung Uk Bae Journal of the Korean Medical Association.2022; 65(9): 577. CrossRef
Multidisciplinary Treatment Strategy for Early Colon Cancer: A Review-An English Version Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim Journal of the Anus, Rectum and Colon.2022; 6(4): 203. CrossRef
Current Status and Future of Robotic Surgery for Colorectal Cancer-An English Version Sung Uk Bae Journal of the Anus, Rectum and Colon.2022; 6(4): 221. CrossRef
It Is a Pleasure to Announce the Issue Titled “Master Class 2021” in Annals of Coloproctology In Ja Park Annals of Coloproctology.2021; 37(6): 349. CrossRef
Reviews
Malignant disease, Rectal cancer,Prognosis and adjuvant therapy,Colorectal cancer
Despite innovative advancements, distally located rectal cancer remains a critical disease of challenging management. The crucial location of the tumor predisposes it to a circumferential resection margin (CRM) that tends to involve the anal sphincter complex and surrounding organs, with a high incidence of delayed anastomotic complications and the risk of the pelvic sidewall or rarely inguinal lymph node metastases. In this regard, colorectal surgeons should be aware of other issues beyond total mesorectal excision (TME) performance. For decades, the concept of extralevator abdominoperineal resection to avoid compromised CRM has been introduced. However, the complexity of deep pelvic dissection with poor visualization in low-lying rectal cancer has led to transanal TME. In contrast, neoadjuvant chemoradiotherapy (NCRT) has allowed for the execution of more sphincter-saving procedures without oncologic compromise. Significant tumor regression after NCRT and complete pathologic response also permit applying the watch-and-wait protocol in some cases, now with more solid evidence. This review article will introduce the current surgical treatment options, their indication and technical details, and recent oncologic and functional outcomes. Lastly, the novel characteristics of distal rectal cancer, such as pelvic sidewall and inguinal lymph node metastases, will be discussed along with its tailored and individualized treatment approach.
Citations
Citations to this article as recorded by
Oncologic impact of technical difficulties during the early experience with laparoscopic surgery for colorectal cancer: long-term follow-up results of a prospective cohort study Hong-min Ahn, Tae Gyun Lee, Hye-Rim Shin, Jeehye Lee, In Jun Yang, Jung Wook Suh, Heung-Kwon Oh, Duck-Woo Kim, Sung-Bum Kang Current Problems in Surgery.2025; 63: 101694. CrossRef
Comparative efficacy analysis of laparoscopic-assisted transanal total mesorectal excision vs laparoscopic transanal mesorectal excision for low-lying rectal cancer Feng Lu, Shu-Guang Tan, Juan Zuo, Hai-Hua Jiang, Jian-Hua Wang, Yu-Ping Jiang World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Risk factors influencing sphincter preservation in laparoscopic radical rectal cancer surgery Jia-Rui Liu, Jin Zhang, Xiang-Long Duan World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Clinical using of innovative biodegradable stent with extension sleeve in Ta_tme for low rectal cancer with high risk of anastomotic leakage Rongrong Hao, Wensheng Wang, Yuanhang Ma, Jianghong Chen, Yunbo Li, Yang Yang, Dan Ma, Zhicao Zhang Scientific Reports.2025;[Epub] CrossRef
Robotic-assisted colorectal surgery in colorectal cancer management: a narrative review of clinical efficacy and multidisciplinary integration Engeng Chen, Li Chen, Wei Zhang Frontiers in Oncology.2025;[Epub] CrossRef
Radiomic Features of Mesorectal Fat as Indicators of Response in Rectal Cancer Patients Undergoing Neoadjuvant Therapy Francesca Treballi, Ginevra Danti, Sofia Boccioli, Sebastiano Paolucci, Simone Busoni, Linda Calistri, Vittorio Miele Tomography.2025; 11(4): 44. CrossRef
Unlocking the in vivo therapeutic potential of radiation-activated photodynamic therapy for locally advanced rectal cancer with lymph node involvement Rui Sang, Sheri Nixdorf, Tzongtyng Hung, Carl Power, Fei Deng, Thuy Anh Bui, Alexander Engel, Ewa M. Goldys, Wei Deng eBioMedicine.2025; 116: 105724. CrossRef
MRI Monitoring of Locally Advanced Rectal Cancer in Watch and Wait Patients Jian Zhao, Kanghua Huang, Akao Zhu, Jinghan Zhu, Yimin Fang, Xiaofeng Zhou, Hao Jiang, Li Shen, Haiyan Chen Clinical Colorectal Cancer.2025;[Epub] CrossRef
Real‐World Long‐Term Outcomes of Operated and Non‐Operated Rectal Cancer in the Elderly: A 14‐Year Retrospective Multicentre Study Harun Demir, Gül Kanyılmaz, İbrahim Babalıoğlu, Bedriye Doğan, Meryem Aktan, Berrin Benli Yavuz, Ayşe Sümeyye Safi Journal of Medical Imaging and Radiation Oncology.2025;[Epub] CrossRef
Sagittal FOCUS-MUSE Diffusion-weighted Imaging MRI Improves the Accuracy of Rectal Cancer Location: A Prospective Observational Study Jingjing Liu, Wei Sun, Shujie Zhang, Gengyun Miao, Lamei Deng, Mengsu Zeng, Liheng Liu Academic Radiology.2025;[Epub] CrossRef
Personalized Treatment Modalities for Rectal Cancer: Advances in Neoadjuvant Treatment Nussara Pakvisal, Leontios Pappas, Bennett A. Caughey, Rocco Ricciardi, Aparna Parikh Journal of Clinical Medicine.2025; 14(13): 4411. CrossRef
Elderly Rectal Cancer: An Updated Review Chih-Kai Huang, Chi-Hsiu Shih, Yung-Shuo Kao Current Oncology Reports.2024; 26(2): 181. CrossRef
Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes Chungyeop Lee, In Ja Park The World Journal of Men's Health.2024; 42(2): 304. CrossRef
Robotic-Assisted versus Laparoscopic Surgery for Rectal Cancer: An Analysis of Clinical and Financial Outcomes from a Tertiary Referral Center Jasper Max Gebhardt, Neno Werner, Andrea Stroux, Frank Förster, Ioannis Pozios, Claudia Seifarth, Christian Schineis, Benjamin Weixler, Katharina Beyer, Johannes Christian Lauscher Journal of Clinical Medicine.2024; 13(6): 1795. CrossRef
Study of surgical feasibility and outcome of laparoscopic surgery in malignant rectal tumors Islam Abdelkhalek, Galal AbuElnagah, Tarek Elfayoumi, Ahmed shoukry Hafez, Mohamed Asal Alexandria Journal of Medicine.2024; 60(1): 113. CrossRef
Postoperative Imaging Findings of Colorectal Surgery: A Pictorial Essay Inkeon Yeo, Myung-Won Yoo, Seong Jin Park, Sung Kyoung Moon Journal of the Korean Society of Radiology.2024; 85(4): 727. CrossRef
Complications Rate and Related Factors After Laparoscopic Sphincter-Preserving Total Mesorectal Excision for Low Rectal Cancer: A Single-Center Study in Vietnam Ly Huu Phu, Ho Tat Bang, Ung Van Viet, Hoang Danh Tan, Nguyen Trung Tin Cureus.2024;[Epub] CrossRef
Tailoring rectal cancer surgery: Surgical approaches and anatomical insights during deep pelvic dissection for optimal outcomes in low‐lying rectal cancer Youn Young Park, Nam Kyu Kim Annals of Gastroenterological Surgery.2024; 8(5): 761. CrossRef
Personalized Decisional Algorithms for Soft Tissue Defect Reconstruction after Abdominoperineal Resection for Low-Lying Rectal Cancers Dan Cristian Moraru, Mihaela Pertea, Stefana Luca, Valentin Bejan, Andrian Panuta, Raluca Tatar, Dan Mircea Enescu, Dragos Viorel Scripcariu, Viorel Scripcariu Current Oncology.2024; 31(6): 3253. CrossRef
Comparative analysis of organ preservation attempt and radical surgery in clinical T2N0 mid to low rectal cancer Hyeung-min Park, Jaram Lee, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim International Journal of Colorectal Disease.2024;[Epub] CrossRef
Essential knowledge and technical tips for total mesorectal excision and related procedures for rectal cancer Min Soo Cho, Hyeon Woo Bae, Nam Kyu Kim Annals of Coloproctology.2024; 40(4): 384. CrossRef
The role of robotic-assisted surgery in the management of rectal cancer: a systematic review and meta-analysis Chenxiong Zhang, Hao Tan, Han Xu, Jiaming Ding International Journal of Surgery.2024; 110(10): 6282. CrossRef
Endoscopic submucosal dissection for superficial ultra-low rectal tumors: outcomes and predictive factors for procedure difficulty Yinxin Wu American Journal of Cancer Research.2024; 14(12): 5784. CrossRef
Pathologic Implications of Magnetic Resonance Imaging-detected Extramural Venous Invasion of Rectal Cancer Hyun Gu Lee, Chan Wook Kim, Jong Keon Jang, Seong Ho Park, Young Il Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim Clinical Colorectal Cancer.2023; 22(1): 129. CrossRef
Customized Denonvilliers’ Fascia Excision: An Advanced Total Mesorectal Excision Technique for Anteriorly Located Rectal Cancer Sung Uk Bae, Cristopher Varela, Manar Nassr, Nam Kyu Kim Diseases of the Colon & Rectum.2023; 66(6): e304. CrossRef
Organ preservation for early rectal cancer using preoperative chemoradiotherapy Gyung Mo Son Annals of Coloproctology.2023; 39(3): 191. CrossRef
The Safe Values of Quantitative Perfusion Parameters of ICG Angiography Based on Tissue Oxygenation of Hyperspectral Imaging for Laparoscopic Colorectal Surgery: A Prospective Observational Study Gyung Son, Armaan Nazir, Mi Yun, In Lee, Sun Im, Jae Kwak, Sang-Ho Park, Kwang-Ryul Baek, Ines Gockel Biomedicines.2023; 11(7): 2029. CrossRef
International Society of University Colon and Rectal Surgeons survey of surgeons’ preference on rectal cancer treatment Audrius Dulskas, Philip F. Caushaj, Domas Grigoravicius, Liu Zheng, Richard Fortunato, Joseph W. Nunoo-Mensah, Narimantas E. Samalavicius Annals of Coloproctology.2023; 39(4): 307. CrossRef
Clinical Significance of Combining Preoperative and Postoperative Albumin-Bilirubin Score in Colorectal Cancer Doyoun Kim, Jae-Hoon Lee, Eun-Suk Cho, Su-Jin Shin, Hye Sun Lee, Hwa-Hee Koh, Kang Young Lee, Jeonghyun Kang Cancer Research and Treatment.2023; 55(4): 1261. CrossRef
Do Laparoscopic Approaches Ensure Oncological Safety and Prognosis for Serosa-Exposed Colon Cancer? A Comparative Study against the Open Approach Ji-Hyun Seo, In-Ja Park Cancers.2023; 15(21): 5211. CrossRef
Low anterior resection syndrome: is it predictable? Dong Hyun Kang Annals of Coloproctology.2023; 39(5): 373. CrossRef
Beyond the Horizon: Unveiling the Frontiers of Rectal Cancer Research and Treatment Reda H Mithany, M Hasaan Shahid, Shenouda Abdallah, Mark Abdelmaseeh, Mina Manasseh, Farid Gerges, Andrew Wanees, Mohamed S Mohamed, Mina W Hakim, Samana Aslam, Nesma Daniel Cureus.2023;[Epub] CrossRef
Optimal surgical techniques for curative resection of the rectal cancer Hyeon Woo Bae, Nam Kyu Kim Formosan Journal of Surgery.2023; 56(6): 171. CrossRef
Unveiling the profound advantages of total neoadjuvant therapy in rectal cancer: a trailblazing exploration Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Donghyoun Lee, Chinock Cheong Annals of Surgical Treatment and Research.2023; 105(6): 341. CrossRef
Advances in the Treatment of Colorectal Cancer with Peritoneal Metastases: A Focus on Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Youngbae Jeon, Eun Jung Park The Ewha Medical Journal.2023;[Epub] CrossRef
How Can We Improve the Tumor Response to Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer? Jeonghee Han The Ewha Medical Journal.2023;[Epub] CrossRef
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery Hyun Gu Lee The Ewha Medical Journal.2023;[Epub] CrossRef
Surgical Techniques for Transanal Local Excision for Early Rectal Cancer Gyoung Tae Noh The Ewha Medical Journal.2023;[Epub] CrossRef
Influence of the COVID-19 Pandemic on the Treatment Patterns and Outcomes of Colorectal Cancer In Ja Park The Ewha Medical Journal.2023;[Epub] CrossRef
Epidemiologie, Diagnostik und Therapie des Rektumkarzinoms Maurice Vuattoux, Soleen Stocker-Ghafoor, Hatice Bunea, Christoph Kettelhack, Andreas Wicki, Frank B. Zimmermann InFo Hämatologie + Onkologie.2022; 25(3): 44. CrossRef
Current status and role of robotic approach in patients with low-lying rectal cancer Hyo Seon Ryu, Jin Kim Annals of Surgical Treatment and Research.2022; 103(1): 1. CrossRef
Multidisciplinary treatment strategy for early colon cancer Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim Journal of the Korean Medical Association.2022; 65(9): 558. CrossRef
Direction of diagnosis and treatment improvement in colorectal cancer In Ja Park Journal of the Korean Medical Association.2022; 65(9): 540. CrossRef
Robotic surgery for colorectal cancer Sung Uk Bae Journal of the Korean Medical Association.2022; 65(9): 577. CrossRef
Current Status and Future of Robotic Surgery for Colorectal Cancer-An English Version Sung Uk Bae Journal of the Anus, Rectum and Colon.2022; 6(4): 221. CrossRef
Multidisciplinary Treatment Strategy for Early Colon Cancer: A Review-An English Version Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim Journal of the Anus, Rectum and Colon.2022; 6(4): 203. CrossRef
Low Anterior Resection Syndrome: Pathophysiology, Risk Factors, and Current Management Seung Mi Yeo, Gyung Mo Son The Ewha Medical Journal.2022;[Epub] CrossRef
Robot-Assisted Colorectal Surgery Young Il Kim The Ewha Medical Journal.2022;[Epub] CrossRef
Update on Diagnosis and Treatment of Colorectal
Cancer Chan Wook Kim The Ewha Medical Journal.2022;[Epub] CrossRef
The watch-and-wait strategy versus radical resection for rectal cancer patients with a good response (≤ycT2) after neoadjuvant chemoradiotherapy Chungyeop Lee, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim Annals of Surgical Treatment and Research.2022; 103(6): 350. CrossRef
It Is a Pleasure to Announce the Issue Titled “Master Class 2021” in Annals of Coloproctology In Ja Park Annals of Coloproctology.2021; 37(6): 349. CrossRef
Malignant disease,Prognosis and adjuvant therapy,Colorectal cancer,Surgical technique
From the perspective of survival outcomes, the cancer survival of colorectal cancer (CRC) in the whole stage has improved. Peritoneal metastasis (PM) is found in approximately 8% to 15% of patients with CRC, with a poorer prognosis than that associated with other sites of metastases. Randomized controlled trials and up-to-date meta-analyses provide firm evidence that cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) could significantly improve overall survival compared with systemic chemotherapy alone in selected patients with CRC-PM. Practical guidelines recommend that the management of CRC-PM should be led by a multidisciplinary team carried out in experienced centers and consider CRS plus HIPEC for selected patients. In this review, we aim to provide the latest results of land mark studies and an overview of recent insights with regard to the management of CRC-PM.
Citations
Citations to this article as recorded by
Molecular characterization of Pseudomyxoma peritonei with single-cell and bulk RNA sequencing Ye Jin Ha, Seong-Hwan Park, Seon-Kyu Kim, Ka Hee Tak, Jeong-Hwan Kim, Chan Wook Kim, Yong Sik Yoon, Seon-Young Kim, Jong Lyul Lee Scientific Data.2025;[Epub] CrossRef
Discovery of WEE1 Kinase Inhibitors with Potent Activity against Patient-Derived, Metastatic Colorectal Cancer Organoids Joel L. Syphers, Josephine A. Wright, Shen Liu, Yi Sing Gee, Fan Gao, Ramesh Mudududdla, Da Qing Che, Aeson Chang, Erica K. Sloan, Vignesh Narasimhan, Alexander Heriot, Robert G. Ramsay, Rebekah de Nys, Tharindie N. Silva, Laura Vrbanac, Tarik Sammour, Ma Journal of Medicinal Chemistry.2025; 68(8): 8065. CrossRef
A Feasibility Study of Mass-Based Response Drug Screening to Guide Personalized Hyperthermic Intraperitoneal Chemotherapy for Appendiceal and Colorectal Adenocarcinoma with Peritoneal Metastasis Justin M. Bader, Ava Ospina, Sean Liu, Biren Reddy, Princy Gupta, Ricarda Tomlin, Michael Cecchini, Raghav Sundar, Kiran Turaga Annals of Surgical Oncology.2025;[Epub] CrossRef
CILP2 is a potential biomarker for the prediction and therapeutic target of peritoneal metastases in colorectal cancer Ye Jin Ha, Seong-Hwan Park, Ka Hee Tak, Jong Lyul Lee, Chan Wook Kim, Jeong-Hwan Kim, Seon-Young Kim, Seon-Kyu Kim, Yong Sik Yoon Scientific Reports.2024;[Epub] CrossRef
Comparison of EPIC Versus HIPEC in the Treatment of Colorectal Peritoneal Metastases and Appendix Tumors Using Inverse Probability of Treatment Weighting Min Hye Jeong, Su Jin Kang, Soo Yeun Park, Sang Gyu Kwak, An Na Seo, Suehyun Park, Jun Seok Park, Hye Jin Kim, Gyu-Seog Choi Annals of Surgical Oncology.2024; 31(10): 7111. CrossRef
Albumin Leakage Level during Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Is Associated with Major Complications Hyun-Chang Kim, Dong Woo Han, Eun Jung Park, Yeon Hwa Hong, Young Song Cancers.2024; 16(16): 2874. CrossRef
Inflammatory and nutritional markers in colorectal cancer: Implications for prognosis and treatment Mesut Tez World Journal of Clinical Oncology.2024; 15(10): 1264. CrossRef
Analgesic effects of combined transversus abdominis plane block and intramuscular electrical stimulation in patients undergoing cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy: a randomized controlled trial Hyun-Chang Kim, Jinyoung Park, Jinyoung Oh, Minjae Kim, Eun Jung Park, Seung Hyuk Baik, Young Song International Journal of Surgery.2023; 109(5): 1199. CrossRef
Do Laparoscopic Approaches Ensure Oncological Safety and Prognosis for Serosa-Exposed Colon Cancer? A Comparative Study against the Open Approach Ji-Hyun Seo, In-Ja Park Cancers.2023; 15(21): 5211. CrossRef
Fluorescence-guided colorectal surgery: applications, clinical results, and protocols Jin-Min Jung, In Ja Park, Eun Jung Park, Gyung Mo Son Annals of Surgical Treatment and Research.2023; 105(5): 252. CrossRef
Improving nanochemoimmunotherapy efficacy by boosting “eat-me” signaling and downregulating “don't-eat-me” signaling with Ganoderma lucidum polysaccharide-based drug delivery Guibin Pang, Siqi Wei, Jian Zhao, Fu-Jun Wang Journal of Materials Chemistry B.2023; 11(48): 11562. CrossRef
Effect of Intraperitoneal Chemotherapy with Regorafenib on IL-6 and TNF-α Levels and Peritoneal Cytology: Experimental Study in Rats with Colorectal Peritoneal Carcinomatosis Stefanos Bitsianis, Ioannis Mantzoros, Elissavet Anestiadou, Panagiotis Christidis, Christos Chatzakis, Konstantinos Zapsalis, Savvas Symeonidis, Georgios Ntampakis, Kalliopi Domvri, Anastasia Tsakona, Chryssa Bekiari, Orestis Ioannidis, Stamatios Aggelop Journal of Clinical Medicine.2023; 12(23): 7267. CrossRef
Recurrence Patterns and Risk Factors after Curative Resection for Colorectal Cancer: Insights for Postoperative Surveillance Strategies Hyo Seon Ryu, Jin Kim, Ye Ryung Park, Eun Hae Cho, Jeong Min Choo, Ji-Seon Kim, Se-Jin Baek, Jung-Myun Kwak Cancers.2023; 15(24): 5791. CrossRef
Advances in the Treatment of Colorectal Cancer with Peritoneal Metastases: A Focus on Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Youngbae Jeon, Eun Jung Park The Ewha Medical Journal.2023;[Epub] CrossRef
Influence of the COVID-19 Pandemic on the Treatment Patterns and Outcomes of Colorectal Cancer In Ja Park The Ewha Medical Journal.2023;[Epub] CrossRef
Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy versus R0 resection for resectable colorectal cancer with peritoneal metastases and low peritoneal cancer index scores: A collaborative observational study from Korea and Japan Daichi Kitaguchi, Eun Jung Park, Seung Hyuk Baik, Shoma Sasaki, Yuichiro Tsukada, Masaaki Ito International Journal of Surgery.2023;[Epub] CrossRef
The Onset of In-Vivo Dehydration in Gas -Based Intraperitoneal Hyperthermia and Its Cytotoxic Effects on Colon Cancer Cells Agata Diakun, Tanja Khosrawipour, Agata Mikolajczyk-Martinez, Jakub Nicpoń, Zdzisław Kiełbowicz, Przemysław Prządka, Bartłomiej Liszka, Wojciech Kielan, Kacper Zielinski, Pawel Migdal, Hien Lau, Shiri Li, Veria Khosrawipour Frontiers in Oncology.2022;[Epub] CrossRef
Patients with Metachronous Peritoneal Metastatic Mucinous Colorectal Adenocarcinoma Benefit More from Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) than Their Synchronous Counterparts Zoltan Herold, Miklos Acs, Attila Marcell Szasz, Katalin Olasz, Jana Hussong, Max Mayr, Magdolna Dank, Pompiliu Piso Cancers.2022; 14(16): 3978. CrossRef
ASO Author Reflections: Is it Correct to Use 5% Dextrose Solution as a Carrier Fluid for Oxaliplatin-based HIPEC? Eun Jung Park, Sung-Joo Hwang, Seung Hyuk Baik Annals of Surgical Oncology.2022; 29(13): 8593. CrossRef
Pharmacologic Effects of Oxaliplatin Instability in Chloride-Containing Carrier Fluids on the Hyperthermic Intraperitoneal Chemotherapy to Treat Colorectal Cancer In Vitro and In Vivo Eun Jung Park, Junhyun Ahn, Sharif Md Abuzar, Kyung Su Park, Sung-Joo Hwang, Seung Hyuk Baik Annals of Surgical Oncology.2022; 29(13): 8583. CrossRef
Benign multicystic mesothelioma of appendiceal origin treated by hyperthermic intraperitoneal chemotherapy: A case report Suk Jun Lee, Ji Hae Nahm, Jeonghyun Kang, Seung Hyuk Baik, Eun Jung Park International Journal of Surgery Case Reports.2022; 99: 107665. CrossRef
Molecular analyses of peritoneal metastasis from colorectal cancer Chang Hyun Kim Journal of the Korean Medical Association.2022; 65(9): 586. CrossRef
Surgical treatment for metastatic colorectal cancer Eun Jung Park, Seung Hyuk Baik Journal of the Korean Medical Association.2022; 65(9): 568. CrossRef
Direction of diagnosis and treatment improvement in colorectal cancer In Ja Park Journal of the Korean Medical Association.2022; 65(9): 540. CrossRef
Recent Advance in the Surgical Treatment of Metastatic Colorectal Cancer-An English Version Eun Jung Park, Seung Hyuk Baik Journal of the Anus, Rectum and Colon.2022; 6(4): 213. CrossRef
Molecular Analyses in Peritoneal Metastasis from Colorectal Cancer: A Review-An English Version Chang Hyun Kim Journal of the Anus, Rectum and Colon.2022; 6(4): 197. CrossRef
Update on Diagnosis and Treatment of Colorectal
Cancer Chan Wook Kim The Ewha Medical Journal.2022;[Epub] CrossRef
It Is a Pleasure to Announce the Issue Titled “Master Class 2021” in Annals of Coloproctology In Ja Park Annals of Coloproctology.2021; 37(6): 349. CrossRef
Malignant disease,Prognosis and adjuvant therapy,Colorectal cancer,Minimally invasive surgery,Surgical technique
Gyung Mo Son, In Young Lee, Yoon Suk Lee, Bong-Hyeon Kye, Hyeon-Min Cho, Je-Ho Jang, Chang-Nam Kim, Kil Yeon Lee, Suk-Hwan Lee, Jun-Gi Kim, On behalf of The Korean Laparoscopic Colorectal Surgery Study Group
Ann Coloproctol. 2021;37(6):434-444. Published online December 8, 2021
Colon cancer treatment is on the way to evolution over several decades. The minimally invasive surgery has improved postoperative short-term outcomes. Adjuvant chemotherapy has prolonged the survival of advanced colon cancer patients. Hohenberger proposed the noble concept of complete mesocolic excision (CME) which consists of 3 components: plane surgery, sufficient longitudinal bowel resection, and central vascular ligation (CVL). Mesocolic plane surgery shares the same surgical principle of total mesorectal excision, which is maintaining the intact mesothelial envelope. However, there remain debates about the extent of bowel resection and the level of CVL for maximizing lymph node dissection. There is no solid clinical evidence for the oncological necessity and benefit of extended radical dissection in right hemicolectomy. CME with CVL based on open surgery has been adopted in laparoscopic surgery. So, it is also necessary to look at how the CME could be transformed and successfully implanted in the laparoscopic era. Recent rapid advances in surgical technology and cancer biology are preparing for fundamental changes in cancer surgery. In this study, we reviewed the history, oncological necessity, and compatibility of CME for the right hemicolectomy in the laparoscopic era and outline the new perspectives on the evolution of cancer surgery.
Citations
Citations to this article as recorded by
Optimal extent of lymph node dissection in clinical early-stage right colon cancer: a retrospective analysis Hyeung-min Park, Jaram Lee, Soo Young Lee, Suk Hee Heo, Yong Yeon Jeong, Hyeong Rok Kim, Chang Hyun Kim Annals of Surgical Treatment and Research.2025; 108(1): 49. CrossRef
Laparoscopic right hemicolectomy: a SICE (Società Italiana di Chirurgia Endoscopica e Nuove tecnologie) network prospective study on the approach to right colon lymphadenectomy in Italy: is there a standard?—CoDIG 2 (ColonDx Italian Group) G. Anania, M. Chiozza, A. Campagnaro, F. Bagolini, G. Resta, D. Azzolina, G. Silecchia, R. Cirocchi, A. Agrusa, D. Cuccurullo, M. Guerrieri, V. Adamo, M. Ammendola, P. Angelini, M. Annecchiarico, G. Aprea, F. Autori, G. Baldazzi, A. Balla, G. Baronio, G. Surgical Endoscopy.2024; 38(3): 1432. CrossRef
Retrocaecal, supracolic and medial dissection (the RESUME approach) as an optimal surgical procedure for right‐sided colon cancer—A Video Vignette Hong‐min Ahn, Min Hyeong Jo, Mi Jeong Choi, Heung‐Kwon Oh, Duck‐Woo Kim, Sung‐Bum Kang Colorectal Disease.2024; 26(7): 1480. CrossRef
Surgical treatment of right colon cancer A. A. Nevolskikh, V. A. Avdeenko, I. P. Reznik, T. P. Pochuev, R. F. Zibirov, S. A. Ivanov, A. D. Kaprin Siberian journal of oncology.2024; 23(3): 133. CrossRef
Effect of Fluorescence Lymph Node Mapping on Improving Diagnostic Values of CT D3 Lymph Node Staging for Right-Sided Colon Cancer Gyung Mo Son, Tae Un Kim, Mi Sook Yun, ChangYeop Kim, In Young Lee, Su Bum Park, Dong-Hoon Shin, Gi Won Ha Cancers.2024; 16(20): 3496. CrossRef
A comparison of the efficacy and safety of natural orifice specimen extraction and conventional laparoscopic surgery in patients with sigmoid colon/high rectal cancer Qiang He, Jing Huang, Liyun Niu, Chunbao Zhai Journal of Surgical Oncology.2023; 127(7): 1160. CrossRef
Effect of intracorporeal anastomosis on postoperative ileus after laparoscopic right colectomy Sangwoo Kim, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek, Young-Gil Son Annals of Surgical Treatment and Research.2023; 104(3): 156. CrossRef
Surgical and oncological outcomes of laparoscopic right hemicolectomy (D3 + CME) for colon cancer: A prospective single-center cohort study Xiaolin Wu, Yixin Tong, Daxing Xie, Haijie Li, Jie Shen, Jianping Gong Surgical Endoscopy.2023; 37(8): 6107. CrossRef
Incidence and survival of adenocarcinoma with mixed subtypes in patients with colorectal cancer Fan Zhang, Boqi Xu, Yao Peng, Zhongqi Mao, Shan Tong International Journal of Colorectal Disease.2023;[Epub] CrossRef
Clinical Effectiveness of Fluorescence Lymph Node Mapping Using ICG for Laparoscopic Right Hemicolectomy: A Prospective Case–Control Study Gyung Mo Son, Mi Sook Yun, In Young Lee, Sun Bin Im, Kyung Hee Kim, Su Bum Park, Tae Un Kim, Dong-Hoon Shin, Armaan M. Nazir, Gi Won Ha Cancers.2023; 15(20): 4927. CrossRef
Early-Onset Colon Cancer: A Narrative Review of Its Pathogenesis, Clinical Presentation, Treatment, and Prognosis Elvina C Lingas Cureus.2023;[Epub] CrossRef
Do Laparoscopic Approaches Ensure Oncological Safety and Prognosis for Serosa-Exposed Colon Cancer? A Comparative Study against the Open Approach Ji-Hyun Seo, In-Ja Park Cancers.2023; 15(21): 5211. CrossRef
Ausmaß und Technik der chirurgischen Resektion beim Kolonkarzinom Christoph Holmer coloproctology.2022; 44(3): 149. CrossRef
Letter to the Editor Reply: ‘Mesocolon Excision in Right Colon Cancer: Is it a Real Oncological Procedure or a Mere Surgical Act?’ Tamara Díaz Vico, Luis Joaquín García Flórez Annals of Surgical Oncology.2022; 29(9): 5855. CrossRef
Medical disease and ambulatory surgery, new insights in patient selection based on medical disease Thomas Fuchs-Buder, Jacob Rosenberg Current Opinion in Anaesthesiology.2022; 35(3): 385. CrossRef
Is the oncological impact of vascular invasion more important in right colon cancer? Gyung Mo Son Journal of Minimally Invasive Surgery.2022; 25(2): 49. CrossRef
Ileal long-segment ischemia after the unintended ligation of variant ileal branch during laparoscopic right hemicolectomy Gyung Mo Son, Tae Un Kim, Dong-Hoon Shin, Joo-Young Na, In Young Lee, Shin Hoo Park Journal of Minimally Invasive Surgery.2022; 25(3): 116. CrossRef
Multidisciplinary treatment strategy for early colon cancer Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim Journal of the Korean Medical Association.2022; 65(9): 558. CrossRef
Direction of diagnosis and treatment improvement in colorectal cancer In Ja Park Journal of the Korean Medical Association.2022; 65(9): 540. CrossRef
Multidisciplinary Treatment Strategy for Early Colon Cancer: A Review-An English Version Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim Journal of the Anus, Rectum and Colon.2022; 6(4): 203. CrossRef
Robot-Assisted Colorectal Surgery Young Il Kim The Ewha Medical Journal.2022;[Epub] CrossRef
It Is a Pleasure to Announce the Issue Titled “Master Class 2021” in Annals of Coloproctology In Ja Park Annals of Coloproctology.2021; 37(6): 349. CrossRef