Improving the outcomes in oncological colorectal surgery.

Area of Science:

• Surgical Oncology
• Gastrointestinal Surgery
• Perioperative Medicine

Background:

• Colorectal cancer surgery has seen significant advancements over recent decades.
• Preoperative patient optimization strategies have emerged to improve surgical outcomes.
• Enhanced recovery programs (ERPs) and fast-track surgery protocols have been implemented to reduce hospital stays and complications.

Purpose of the Study:

• To review major perioperative improvements in colorectal cancer surgery.
• To evaluate the impact of preoperative assessments and intraoperative techniques on patient outcomes.
• To discuss the evolution and benefits of laparoscopic surgery in colorectal cancer treatment.

Main Methods:

• Review of perioperative advancements in colorectal cancer surgery.
• Analysis of preoperative risk assessment tools (nutrition, frailty, sarcopenia).
• Evaluation of enhanced recovery programs and laparoscopic surgical techniques.

Main Results:

• Preoperative optimization and ERPs improve postoperative outcomes and reduce hospital stay without compromising safety.
• Laparoscopic colorectal surgery demonstrates superior short-term results compared to open surgery.
• Long-term oncological outcomes (survival, recurrence) for laparoscopic colon cancer surgery are comparable to open procedures, with ongoing evaluation for rectal surgery.

Conclusions:

• Perioperative care in colorectal cancer surgery has substantially improved through risk assessment, optimization, ERPs, and laparoscopy.
• Laparoscopic surgery is a safe and effective approach for colorectal cancer, offering better short-term recovery.
• Continued monitoring is necessary for long-term outcomes, particularly in rectal cancer, and managing complications like anastomotic leakage remains an area for improvement.