[Surgery of cancers of the colon and rectum]

Whatever the technique used for colorectal resection, the carcinologic principles of resection of colorectal cancer must include removal of the cancer with an adequate margin by performing a wide excision of the tumor-bearing area and associated lymphatics. Recent advances in colorectal cancer management concern principally rectal cancer, with new diagnostic tools (i.e. endorectal ultrasound, MRI, CT-scanner), and new surgical procedures (ioff coloanal anastomosis, stapled anastomosis, and local excision) which allow, in most of the cases, a sphincter-saving resection to be performed. Indication of laparoscopic surgery in colorectal cancer remains to be determined. Prognosis of colorectal cancer has not improved for recent years and the 5 year survival rate remains close to 50% after surgical excision. However, recently, adjuvant chemo-and radio-therapy have permitted a significant reduction of local recurrences and an improvement of the overall survival.