Surgery for colorectal carcinoma.

An adequate operation for colorectal carcinoma involves removal of the primary tumor and wide excision of the mesentery with its contained regional lymph nodes and lymphovascular pathways. Enker and DeCosse state that radical resection, i.e., total mesenteric lymphadenectomy encompassing the origins of the complete arterial blood supply to an affected bowel segment has proved to be a rewarding operation in terms of survival in cancer patients. In patients with positive lymph nodes, radical resection is associated with twice the five-year survival rate achieved by more limited operations that spare the root of the mesentery. Details of the various surgical approaches to the resection of colorectal cancer are presented.