Innovations in colorectal surgery

In this review, we summarize the new principles, new ideas and new techniques that have emerged in recent years in the surgical treatment of colon and rectal carcinomas. The paper is a narrative summary, providing a collection of the most recent relevant literature on thematically highlighted aspects of colorectal surgery, based on an independent selection of two surgeons experienced in colorectal surgery. Complete mesocolic excision (CME) and radical lym phadenectomy for colorectal carcinomas, biological differences between right and left colon tumors, and the options for neoadjuvant drug treatment based on tumor biology are evaluated. In the context of rectal cancer, the issues of transanal total mesorectal excision (TaTME), robotic surgery, intersphincteric resections and radicality of lymphad enectomy will be discussed, and finally the principle of organ-sparing recial surgery will be evaluated. Colon and rectal carcinoma surgery have now taken significantly different paths. Technical and technological innovations must be adapted to the pathological and oncological knowledge and adapted to the daily practice as personalized thera peutic options based on a multidisciplinary team decision.