Surgical treatment of colorectal cancer: A multidimensional review

Table 1 Surgical approaches for colorectal cancer: Stages and techniques

Stage	Main surgical procedures	Characteristics and indications
Early palliative surgery	PTR[5], SEMS[6-8], S/B[9], Hartmann's procedure[10]	Used to relieve symptoms like obstruction/bleeding, suitable for early-stage patients or those unable to undergo radical surgery. SEMS is preferred for advanced bowel obstruction relief
Radical surgery	Right/left hemicolectomy[18], hemicolectomy[18], transverse colectomy[18], radical sigmoidectomy[18], D3 lymph node dissection[19,20]	Complete tumor and regional lymph node removal, primarily for locally advanced CRC, to improve DFS and OS
Function-preserving surgery	LAR[24,25], TaTME[24,30-32], TME[30-32], APR[24]	Tumor location-based selection, prioritizing sphincter preservation, especially in low rectal cancers, to maintain quality of life. APR is considered when sphincter preservation is not feasible
Minimally invasive surgery	Laparoscopic surgery[35,38,39], SILS[40,41], TAMIS[42,43], RAS[44,45]	Less trauma, faster recovery, and shorter hospital stays. Robotic and laparoscopic techniques improve surgical precision and reduce complications, particularly in low CRC and obese patients
Precision medicine surgery	Genomic-guided personalized surgery[53,54], AI-assisted surgical decision-making[55-58], liquid biopsy for post-operative monitoring[59,60]	Combines molecular diagnostics, AI, and post-operative monitoring for precise, tailored treatment plans, improving surgical outcomes and recurrence prediction

CRC: Colorectal cancer; SEMS: Self-expanding metal stents; PTR: Primary tumor resection; S/B: Stoma/bypass; DFS: Disease-free survival; OS: Overall survival; LAR: Low anterior resection; TaTME: Transanal total mesorectal excision; TME: Total mesorectal excision; APR: Abdominoperineal resection; MIS: Minimally invasive surgery; SILS: Single incision laparoscopic surgery; TAMIS: Transanal minimally invasive surgery; RAS: Robotic-assisted surgery; AI: Artificial intelligence.