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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Fahad Hasan, M.D.[2] Elliot B. Tapper, M.D., Saarah T. Alkhairy, M.D.

Overview

Surgical resection is the main curative-intent treatment for colon cancer and rectal cancer. Chemotherapy and radiotherapy are sequenced around it according to stage, tumor site, mismatch repair status, and tumor biology.[1][2]

Colon cancer is treated with segmental colectomy and regional lymphadenectomy matched to the tumor's lymphovascular drainage. Mid and low rectal cancer is treated with total mesorectal excision (TME).[1][3]

Two principles govern modern practice:

  • A complete (R0) resection along embryologic planes, with an adequate lymph node harvest, determines oncologic outcome.[1][2]
  • In experienced hands, minimally invasive surgery gives oncologic outcomes equivalent to open surgery, with faster recovery.[4]

Surgery also has defined roles in three other settings:

  • Resectable liver and lung metastases.
  • Emergency presentations: obstruction, perforation, and bleeding.
  • Selected locally advanced disease after neoadjuvant therapy.

Anastomotic leak is the most consequential complication of colorectal resection. Extended resection for hereditary syndromes (familial adenomatous polyposis, Lynch syndrome) is covered in the dedicated chapters.

Surgery

Colon Cancer: Oncologic Principles of Colectomy

Extent of Resection

The extent of colectomy is set by the lymphovascular drainage of the tumor-bearing segment, not by the tumor alone. This is an ASCRS strong recommendation based on moderate-quality evidence (1B).[1]

Standard colectomy by tumor site
Tumor site Standard procedure Key vascular division
Cecum / ascending colon Right colectomy Ileocolic pedicle and right branch of the middle colic artery, divided at their origins[1]
Transverse colon Extended right colectomy or transverse colectomy[5] Individualized; segmental and extended resections have shown comparable long-term outcomes, with fewer complications after segmental resection in several series[1]
Splenic flexure Individualized (segmental or extended) Individualized[1]
Descending / sigmoid colon Left hemicolectomy or sigmoid colectomy[5] Superior rectal and left colic arteries divided at their origin; inferior mesenteric vein divided near the inferior border of the pancreas[1]

Margins, Lymphadenectomy, and Completeness

  • Longitudinal margins: Generally 5–7 cm proximal and distal to the tumor, to clear the at-risk pericolic nodes.[1]
  • Mesenteric resection: Remove the mesentery to the origin of the named primary feeding vessel(s), so that intermediate and central nodes are included.[1]
  • Lymph node yield: Examine at least 12 lymph nodes to assign N0 status.[2][1]
    • Fewer than 12 nodes is a high-risk feature in stage II disease.
    • It should prompt pathologic re-examination of the specimen.
  • En bloc resection: Resect tumors adherent to or invading adjacent structures en bloc with negative margins.
    • Adhesions to a colon cancer contain malignant cells in 34%–84% of cases and must not be divided.
    • This is an ASCRS strong recommendation (1B).[1]
  • Completeness: Positive nodes left behind or gross residual disease constitute an incomplete (R2) resection. Only complete resection is curative.[2]

Malignant Polyp (pT1)

Endoscopic resection followed by surveillance alone may be sufficient for a completely excised pedunculated or sessile malignant polyp that meets all of these criteria:[2]

  • Favorable histology, with well or moderate differentiation.
  • Clear margins (>1–2 mm).
  • No lymphovascular or perineural invasion.

Colectomy with regional lymphadenectomy is warranted for any of the following:[2]

  • A fragmented specimen.
  • Unassessable or positive margins.
  • Unfavorable histology.

Complete Mesocolic Excision and Central Vascular Ligation

Complete mesocolic excision (CME) applies TME principles to the colon (Hohenberger technique):[6][7]

  • Sharp dissection along the avascular embryologic plane removes an intact mesocolic envelope.
  • It is combined with central vascular ligation (CVL) at the vessel origin and D3 nodal clearance.

Evidence:

  • A 2026 meta-analysis of 11 prospective studies (6 RCTs; 4,575 patients) found that CME with CVL significantly improved disease-free and overall survival without increasing morbidity or mortality.[8]
  • CME consistently increases lymph node yield and reduces local recurrence.[7]
  • It has a substantial learning curve and carries a risk of vascular and autonomic nerve injury.[7]

Guideline position:

  • The ASCRS distinguishes CME (completeness of the mesocolic envelope) from extended lymphadenectomy/D3/CVL (level of vascular ligation).
  • It does not recommend routine extended lymphadenectomy. It advises selective harvest of clinically suspicious central nodes instead (weak recommendation, moderate-quality evidence, 2B).[1]

Rectal Cancer: Oncologic Principles

Total Mesorectal Excision

TME is the standard operation for mid and low rectal cancer.[3][9]

  • Technique: Sharp dissection in the areolar plane between the mesorectal fascia (fascia propria) and the endopelvic fascia, removing the rectum and intact mesorectum en bloc.
  • Benefit: Lower rates of positive circumferential resection margin (CRM) and of local recurrence.
  • Plane quality matters: In the MRC CR07/NCIC-CTG CO16 trial, 3-year local recurrence was:[10]
    • 4% with a good (mesorectal) plane of dissection.
    • 13% with a poor (muscularis propria) plane.
  • TME quality grading: Record the grade (complete, near-complete, or incomplete) synoptically. Incomplete TME carries significantly higher local recurrence and cancer-related death.[9]

Procedure Selection and Margins

The following technical standards are ASCRS strong recommendations based on high-quality evidence (1A):[10]

  • Upper-third rectal tumors: Tumor-specific mesorectal excision, with the mesorectum divided ≥5 cm below the distal tumor edge, as part of low anterior resection (LAR).
  • Mid- and lower-third tumors: Full TME to the pelvic floor, as part of ultralow anterior resection or abdominoperineal resection (APR).
  • Distal mural margin:
    • 2 cm is generally adequate.
    • 1 cm is acceptable at or below the mesorectal margin.
    • Shorter margins may be acceptable after a favorable response to neoadjuvant therapy in highly motivated candidates for sphincter preservation.
  • Circumferential resection margin (CRM):
    • Tumor, nodes, or deposits within 1 mm of the mesorectal fascia independently predict worse local recurrence and disease-free survival.
    • Achieving a negative CRM is therefore critical.

APR is indicated when:[10]

  • The tumor directly involves the sphincter complex or levators.
  • The intersphincteric plane is lost.
  • A margin-negative resection would leave unacceptable sphincter function.

Local Excision for Early Rectal Cancer

Transanal local excision, including transanal endoscopic microsurgery (TEM) and transanal minimally invasive surgery (TAMIS), is an option for highly selected early tumors.[3]

NCCN criteria for transanal local excision of rectal cancer
Domain Criterion
Size and circumference <3 cm and <30% of the bowel circumference
Location Within 8 cm of the anal verge
T stage T1 only
Histology Well to moderately differentiated; no lymphovascular or perineural invasion
Nodal status No radiographic adenopathy
Technique Full-thickness excision with ≥10 mm margins

Limitations and special situations:

  • Local excision does not address mesorectal nodes.
  • It is oncologically inferior to radical surgery for tumors with a higher risk of nodal spread.[11]
  • It may be considered for near-complete responders after neoadjuvant therapy who cannot or will not undergo TME.
  • It is not routinely recommended after a clear clinical complete response.[3]

Reconstruction and Fecal Diversion

  • Pouch reconstruction: A colonic J-pouch reduces bowel frequency and urgency for up to 18 months compared with a straight end-to-end anastomosis. A side-to-end anastomosis gives similar results.[10]
  • Diverting loop ileostomy: Consider after LAR, particularly with any of the following:[10]
    • Low anastomosis (<5–8 cm from the anal verge).
    • Male sex.
    • Preoperative radiotherapy.
  • Effect of diversion: A loop ileostomy reduces clinical leak (OR 0.43) and reoperation (OR 0.62), at the cost of stoma-related morbidity.[10]
  • Intraoperative anastomotic assessment: Recommended during LAR (1B). Options include an air-leak test, endoscopy, or indocyanine green (ICG) perfusion assessment.[10]

Surgical Approach

Operative approaches for colorectal cancer
Approach Key evidence Practical role
Open Reference standard for oncologic comparison Preferred for T4 or locally invasive tumors, and for acute obstruction or perforation; NCCN does not recommend laparoscopic resection for T4 tumors[2]
Laparoscopic Oncologically equivalent to open colectomy, with less blood loss, less pain, faster bowel recovery, and shorter stay (ASCRS/SAGES 1A)[4]
COST trial: equivalent 3-year survival across stages[12]
COLOR: equivalent disease-free survival at 10 years[13]
Nationwide cohort data agree[14] 		Default minimally invasive approach for elective colon cancer when expertise is available
Robotic Earlier RCT meta-analysis: oncologic equivalence to laparoscopy, with lower conversion and longer operative time[15]
REAL RCT (1,171 patients, 11 high-volume Chinese centers): see detail below[16] 		Mid and low rectal cancer, especially an anatomically difficult pelvis
Transanal TME (TaTME) TaLaR RCT: 3-year disease-free survival noninferior to laparoscopic TME (82.1% vs 79.4%)[17] "Bottom-up" approach for the low pelvis in experienced centers, particularly where robotics is unavailable

Detail: Robotic Versus Laparoscopic TME

REAL trial (robotic vs laparoscopic) results:[16]

  • 3-year locoregional recurrence: 1.6% vs 4.0% (HR 0.45).
  • 3-year disease-free survival: 87.2% vs 83.4%.
  • Urinary, sexual, and defecatory function: better after robotic surgery.
  • Overall survival: no difference.
  • An accompanying editorial framed these results as a shift from oncologic equivalence toward superiority.[18]

A 2026 RCT-only meta-analysis with GRADE rating found:[19]

  • No significant difference in major complications, CRM positivity, complete TME, or survival.
  • Longer operative time and higher cost with robotics.
  • Low to very low certainty of evidence throughout.

Detail: TaTME

  • Earlier reports of atypical multifocal local recurrence after TaTME warrant careful credentialing.

Metastatic and Locally Advanced Disease

Liver and Lung Metastases

Role of hepatic resection

  • Hepatic resection is the treatment of choice for resectable colorectal liver metastases (CRLM) and the only potentially curative option.[2][20][21]
  • About 20%–30% of patients with liver metastases are surgical candidates.
  • Reported 5-year survival after R0 resection is 20%–58%.

Resectability criteria[2]

  • A complete (R0) resection is anatomically feasible.
  • The future liver remnant has adequate volume and function.
  • There is no unresectable extrahepatic disease.
  • Partial debulking (R1/R2) is not recommended.

Sequencing

  • When both the primary and the metastases are resectable, resect both sites with curative intent.[2]
  • This can be done synchronously or as a staged approach (liver-first or primary-first).

Insufficient liver remnant

Lung metastases

  • Lung metastasectomy follows analogous principles: an R0 primary, complete resection, and preserved pulmonary function.[2]

Thermal ablation

  • For liver lesions ≤3 cm, thermal ablation is now considered equivalent to resection, with less toxicity. Microwave ablation is preferred over radiofrequency ablation.[2][22]
  • The COLLISION trial randomized resectable CRLM to resection versus thermal ablation.[22]
  • Outside this setting, resection is generally prioritized over ablation.

Conversion therapy

  • Initially unresectable CRLM may become resectable after systemic therapy.[23]
  • Resectability is reassessed dynamically, using imaging response, anticipated margins, and RAS/BRAF status.

Locally Unresectable or T4b Primary

  • Clinical T4b or bulky nodal colon cancer: May be treated with neoadjuvant FOLFOX or CAPEOX.[2]
  • Locally unresectable or medically inoperable disease: Managed with systemic therapy with or without radiation, then re-evaluated for conversion to resectability.[2]
  • dMMR/MSI-H tumors: For T4 or bulky primaries, neoadjuvant immune checkpoint inhibitor therapy is preferred (see medical therapy chapter).[2]
  • Asymptomatic primary in metastatic disease: Routine resection is not standard. The decision depends on symptoms and multidisciplinary tumor board review.

Emergency Presentations

About 20% of colon cancers present emergently with obstruction, perforation, or bleeding.[1] The goals are to:

  • Prevent death and sepsis.
  • Achieve the best possible tumor control.
  • Allow timely systemic therapy.
Management of malignant colonic obstruction
Scenario Options Key evidence and caveats
Left-sided obstruction, potentially curable Individualize among:
(1) Self-expanding metal stent (SEMS) as a bridge to surgery
(2) Diverting stoma with interval colectomy
(3) Upfront oncologic segmental resection
(ASCRS 1B)[1] 		Compared with emergency resection, SEMS bridge-to-surgery:
• Increases primary anastomosis and minimally invasive resection rates
• Reduces permanent stoma and postoperative morbidity
• Lowers 30- and 90-day mortality
• Does not change 3- or 5-year disease-free or overall survival[24][25][26]
The ASGE conditionally recommends SEMS bridge-to-surgery.[25]
Caveats: SEMS perforation occurs in about 2%–9% and is associated with increased locoregional recurrence; some meta-analyses report higher recurrence after stenting[1][25]
Right-sided or transverse obstruction, potentially curable Upfront segmental resection with ileocolic anastomosis; SEMS with interval colectomy is an alternative (ASCRS 1C)[1] Upfront resection is safe in most patients[1]
Obstruction from incurable or metastatic disease Palliative colonic stenting is preferred over palliative surgery[25][27] Fewer permanent ostomies, fewer adverse events, and shorter stay, with similar 30-day mortality
Use shared decision-making for patients on, or likely to receive, bevacizumab, because of perforation risk[25]

Complications

Anastomotic Leak

Anastomotic leak (AL) is the most feared complication of colorectal resection.

Rates depend on anastomotic site[28][10]

  • After colon resection: about 2%–8.7%.
  • After LAR: 3%–23%.
  • By anastomosis: up to about 19% for coloanal versus about 0.5% for ileocolic.
ISREC grading of anastomotic leak
Grade Definition
A No active therapeutic intervention required
B Active intervention required, without reoperation
C Reoperation required

Consequences

  • In a 2026 multicenter cohort, AL occurred in fewer than 6% of elective colorectal cancer resections but was associated with severe early postoperative deterioration.[29]
  • After colon cancer resection, AL independently predicts postoperative morbidity and long-term non-oncologic mortality.[30]
    • Overall and relapse-free survival are reduced.
    • Cancer-specific survival was unaffected in this cohort.
  • The association between AL and local recurrence is less consistent.

Risk factors[28][31]

  • Male sex.
  • Obesity.
  • Low rectal anastomosis.
  • Preoperative radiotherapy.
  • Emergency surgery.
  • Hypoalbuminemia.
  • Intraoperative complications.

Timing[31]

  • Early leaks (within 6 days) are mostly technical.
  • Late leaks mostly reflect impaired healing.

Other Complications

Perioperative Care

  • Minimally invasive surgery: Lowers surgical site infection, blood loss, and length of stay compared with open surgery.[4][33]
  • Enhanced recovery after surgery (ERAS) pathways: Further reduce morbidity and length of stay.[4]

Areas of Uncertainty and Guideline Disagreement

Issue Supporting evidence Caveat or opposing position
Routine CME/D3/CVL for colon cancer Meta-analytic survival benefit; common in European and Asian practice[8] ASCRS does not recommend routine extended lymphadenectomy (2B), citing equipoise[1]
Robotic superiority for rectal cancer REAL: lower locoregional recurrence and better function[16] GRADE-rated RCT meta-analysis: no clear overall superiority, higher direct cost, low certainty[19]
Oncologic safety of SEMS Consistent short-term benefit[24][25] A recurrence signal persists in some analyses (fragile, very low certainty); patients who prioritize recurrence risk may prefer emergency surgery[25]
Interval from stent to surgery, or from diagnosis to surgery Delays up to about 12 weeks appear acceptable in some studies No firm interval established; untreated cancer progresses
Extent of resection for transverse and splenic-flexure tumors Segmental resection has fewer complications in several series[1] Data inconsistent; individualize[1]
ICG fluorescence angiography to prevent leak Non-randomized data suggest benefit Recent cohort analyses found no independent protective effect; randomized confirmation pending[29]

Clinical Pearls and Pitfalls

Pearls

  • Twelve or more examined lymph nodes is both a staging requirement and a quality metric. Fewer than 12 is a high-risk feature that requires an adjuvant-therapy discussion in stage II disease.[2][1]
  • A CRM ≤1 mm on pathology, or a threatened CRM on MRI, is the strongest surgical predictor of local recurrence in rectal cancer and drives neoadjuvant therapy decisions.[10]
  • After LAR, a loop ileostomy is preferred over a loop colostomy for diversion because reversal is easier. Counsel patients about high-output dehydration.[2]
  • In curable left-sided obstruction, SEMS or a diverting stoma can turn a likely permanent colostomy into a probable primary anastomosis.[24][25]

Pitfalls

  • Dividing the vascular pedicle before full exploration. Unrecognized carcinomatosis or synchronous disease should change the operative plan before resection begins.
  • Accepting fewer than 12 nodes without requesting re-examination of the specimen.[2]
  • Using laparoscopy for T4, locally invasive, obstructed, or perforated tumors.[2]
  • Attempting a restorative anastomosis in an unprepared, dilated colon in an unstable patient with obstruction. Consider diversion or a stent bridge instead.[1][28]
  • Omitting diversion in high-risk low anastomoses, such as in male patients, irradiated patients, or very low rectal cases.[10]
  • Stenting without accounting for bevacizumab exposure.[25]
  • Using local excision for a clinical complete response instead of surveillance or standard TME.[3]
  • Reflexively resecting an asymptomatic primary in metastatic disease without multidisciplinary review.

References

  1. ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 Vogel JD, Felder SI, Bhama AR; et al. (2022). "The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Colon Cancer". Dis Colon Rectum. 65 (2): 148–177. doi:10.1097/DCR.0000000000002323. PMID 34775402 Check |pmid= value (help).
  2. ↑ 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 National Comprehensive Cancer Network (2026). "NCCN Clinical Practice Guidelines in Oncology: Colon Cancer. Version 2.2026". NCCN. Invalid parameter "for" in <ref> tag. The supported parameters are: dir, follow, group, name.
  3. ↑ 3.0 3.1 3.2 3.3 3.4 National Comprehensive Cancer Network (2026). "NCCN Clinical Practice Guidelines in Oncology: Rectal Cancer. Version 2.2026". NCCN.
  4. ↑ 4.0 4.1 4.2 4.3 Carmichael JC, Keller DS, Baldini G; et al. (2017). "Clinical Practice Guidelines for Enhanced Recovery After Colon and Rectal Surgery From the American Society of Colon and Rectal Surgeons and Society of American Gastrointestinal and Endoscopic Surgeons". Dis Colon Rectum. 60 (8): 761–784. doi:10.1097/DCR.0000000000000883.
  5. ↑ 5.0 5.1 Luther J, Chan AT (2022). "Malignant tumors of the colon". In Wang TC, Camilleri M, Lebwohl B; et al. Yamada's Textbook of Gastroenterology (7th ed.). Hoboken, NJ: Wiley-Blackwell. ISBN 9781119600169.
  6. ↑ Hohenberger W, Weber K, Matzel K, Papadopoulos T, Merkel S (2009). "Standardized surgery for colonic cancer: complete mesocolic excision and central ligation—technical notes and outcome". Colorectal Dis. 11 (4): 354–364. doi:10.1111/j.1463-1318.2008.01735.x. PMID 19016817.
  7. ↑ 7.0 7.1 7.2 Seow-En I, Chen WT (2022). "Complete mesocolic excision with central venous ligation/D3 lymphadenectomy for colon cancer—a comprehensive review of the evidence". Surg Oncol. 42: 101755. doi:10.1016/j.suronc.2022.101755.
  8. ↑ 8.0 8.1 Kitaguchi D, Forgione A, Innocenzi C, Yang Y, Espínola F, Giménez M, Oda T, Marescaux J (2026). "The role of complete mesocolic excision with central vascular ligation in colon cancer surgery: a systematic review and meta-analysis of prospective trials". Eur J Surg Oncol. 52 (4): 111516.
  9. ↑ 9.0 9.1 American College of Surgeons Commission on Cancer (2024). "Optimal Resources for Cancer Care (2020 Standards; updated 2024)". American College of Surgeons.
  10. ↑ 10.00 10.01 10.02 10.03 10.04 10.05 10.06 10.07 10.08 10.09 10.10 You YN, Hardiman KM, Bafford A; et al. (2020). "The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Rectal Cancer". Dis Colon Rectum. 63 (9): 1191–1222. doi:10.1097/DCR.0000000000001762. PMID 33216491 Check |pmid= value (help).
  11. ↑ Motamedi MAK, Mak NT, Brown CJ, Raval MJ, Karimuddin AA, Giustini D, Phang PT (2023). "Local versus radical surgery for early rectal cancer with or without neoadjuvant or adjuvant therapy". Cochrane Database Syst Rev (6): CD002198. doi:10.1002/14651858.CD002198.pub3.
  12. ↑ Nelson H, Sargent DJ, Wieand HS, et al.; Clinical Outcomes of Surgical Therapy Study Group (2004). "A comparison of laparoscopically assisted and open colectomy for colon cancer". N Engl J Med. 350 (20): 2050–2059. doi:10.1056/NEJMoa032651. PMID 15141043.
  13. ↑ Deijen CL, Vasmel JE, de Lange-de Klerk ESM; et al. (2017). "Ten-year outcomes of a randomised trial of laparoscopic versus open surgery for colon cancer". Surg Endosc. 31 (6): 2607–2615. doi:10.1007/s00464-016-5270-6. PMID 27734203.
  14. ↑ Vogelsang RP, Fransgaard T, Falk Klein M, Gögenur I (2022). "Long-term oncological outcomes in patients undergoing laparoscopic versus open surgery for colon cancer: a nationwide cohort study". Colorectal Dis. 24 (4): 439–448. doi:10.1111/codi.16022. PMID 34905273 Check |pmid= value (help).
  15. ↑ Prete FP, Pezzolla A, Prete F, Testini M, Marzaioli R, Patriti A; et al. (2018). "Robotic versus laparoscopic minimally invasive surgery for rectal cancer: a systematic review and meta-analysis of randomized controlled trials". Ann Surg. 267 (6): 1034–1046. PMID 28984644.
  16. ↑ 16.0 16.1 16.2 Feng Q, Yuan W, Li T, et al.; REAL Study Group (2025). "Robotic vs laparoscopic surgery for middle and low rectal cancer: the REAL randomized clinical trial". JAMA. 334 (2): 136–148. doi:10.1001/jama.2025.8123. PMID 40455621 Check |pmid= value (help).
  17. ↑ Zeng Z, Luo S, Zhang H, et al.; Chinese Transanal Endoscopic Surgery Collaborative (CTESC) Group (2025). "Transanal vs laparoscopic total mesorectal excision and 3-year disease-free survival in rectal cancer: the TaLaR randomized clinical trial". JAMA. 333 (9): 774–783. doi:10.1001/jama.2024.24276. PMID 39847361 Check |pmid= value (help).
  18. ↑ Kim MJ, Pappou EP, Smith JJ (2025). "Robotic surgery for rectal cancer—a shift from oncological equivalence to superiority". JAMA. 334 (2): 121–123. doi:10.1001/jama.2025.7019. PMID 40455625 Check |pmid= value (help).
  19. ↑ 19.0 19.1 Choi SJ, Chae G (2026). "Robot-assisted versus laparoscopic surgery for rectal cancer: a systematic review and meta-analysis of randomised trials with GRADE certainty rating". Surg Endosc. doi:10.1007/s00464-026-13273-8. PMID 42581199 Check |pmid= value (help).
  20. ↑ Morris VK, Kennedy EB, Baxter NN; et al. (2023). "Treatment of metastatic colorectal cancer: ASCO guideline". J Clin Oncol. 41 (3): 678–700. doi:10.1200/JCO.22.01690. PMID 36252154 Check |pmid= value (help).
  21. ↑ Keck J, Gaedcke J, Ghadimi M, Lorf T (2022). "Surgical therapy in patients with colorectal liver metastases". Digestion. PMID 35390790 Check |pmid= value (help).
  22. ↑ 22.0 22.1 Folkerts AD, Janczewski LM, Merkow RP (2025). "Liver-directed therapies for colorectal liver metastases". Cancer. doi:10.1002/cncr.70097.
  23. ↑ Newhook TE, Vauthey JN (2022). "Colorectal liver metastases: state-of-the-art management and surgical approaches". Langenbecks Arch Surg. 407 (5). doi:10.1007/s00423-022-02496-7.
  24. ↑ 24.0 24.1 24.2 McHugh FT, Ryan ÉJ, Ryan OK, Tan J, Boland PA, Whelan MC, Kelly ME, McNamara D, Neary PC, O'Riordan JM, Kavanagh DO (2024). "Management strategies for malignant left-sided colonic obstruction: a systematic review and network meta-analysis of randomized controlled trials and propensity score matching studies". Dis Colon Rectum. 67 (7): 878–894. doi:10.1097/DCR.0000000000003256. PMID 38557484 Check |pmid= value (help).
  25. ↑ 25.0 25.1 25.2 25.3 25.4 25.5 25.6 25.7 25.8 ASGE Standards of Practice Committee; Machicado JD, Ngamruengphong S; et al. (2026). "American Society for Gastrointestinal Endoscopy guideline on endoscopic management of benign and malignant colonic strictures". Gastrointest Endosc. 104 (2): 164–181.
  26. ↑ Liew AN, Tan RYM, Lim WM, Arachchi A, Saranasuriya C, Suhardja TS; et al. (2026). "Is there a preferred management option for malignant large bowel obstruction secondary to colorectal cancer: a systematic review and meta-analysis between colonic stents as a bridge to surgery versus emergency surgery?". Colorectal Dis. doi:10.1111/codi.70618.
  27. ↑ Madariaga A, Lau J, Ghoshal A; et al. (2022). "MASCC multidisciplinary evidence-based recommendations for the management of malignant bowel obstruction in advanced cancer". Support Care Cancer. 30 (6): 4711–4728. doi:10.1007/s00520-022-06889-8. PMID 35274188 Check |pmid= value (help).
  28. ↑ 28.0 28.1 28.2 Frasson M, Flor-Lorente B, Rodríguez JL; et al. (2015). "Risk factors for anastomotic leak after colon resection for cancer: multivariate analysis and nomogram from a multicentric, prospective, national study with 3193 patients". Ann Surg. 262 (2): 321–330. doi:10.1097/SLA.0000000000000973. PMID 25361221.
  29. ↑ 29.0 29.1 Cwaliński T, Kaczor P, Kapturkiewicz B; et al. (2026). "Clinical burden of anastomotic leak after elective colorectal cancer surgery: a multicenter cohort study". J Clin Med. 15 (17): 6903. doi:10.3390/jcm15176903.
  30. ↑ Gosavi R, Yap R, Bell S, Wilkins S, Asghari-Jafarabadi M, McMurrick P (2025). "Anastomotic leak following colon cancer resection: an independent predictor of non-oncologic mortality and morbidity". J Surg Oncol. 132 (7): 1250–1256. doi:10.1002/jso.70100. PMID 40981475 Check |pmid= value (help).
  31. ↑ 31.0 31.1 Sparreboom CL, van Groningen JT, Lingsma HF; et al. (2018). "Different risk factors for early and late colorectal anastomotic leakage in a nationwide audit". Dis Colon Rectum. 61 (11): 1258–1266. doi:10.1097/DCR.0000000000001202. PMID 30239395.
  32. ↑ 32.0 32.1 Scarborough JE, Schumacher J, Kent KC; et al. (2017). "Associations of specific postoperative complications with outcomes after elective colon resection". JAMA Surg. 152 (2): e164681.
  33. ↑ Zahidli Z, Topal U, Aydin İ, Kayci Y, Yavuz B, Yildirim A, Saritaş AG, Eray İC, Alabaz Ö (2026). "Comparison of open and laparoscopic surgical techniques in colorectal cancer surgery: early and late results". Medicine (Baltimore). 105 (23): e49207. doi:10.1097/MD.0000000000049207. PMID 42260885 Check |pmid= value (help).
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