Modern Surgical Techniques for Colorectal Cancer: Reducing Recurrence and Improving Survival

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• The Surgeon as a Key Prognostic Factor
• Total Mesorectal Excision (TME) for Rectal Cancer
• Benefits and Outcomes of TME Surgery
• Mesocolic Excision for Colon Cancer
• The Critical Importance of Primary Surgical Strategy
• The Role of a Medical Second Opinion
• Full Transcript

The Surgeon as a Key Prognostic Factor

Dr. Martin Schilling, MD, states that the surgeon is the most important prognostic factor in colorectal cancer treatment. A correct surgical operation has the largest impact on a patient's long-term survival from colon cancer or rectal cancer. The surgeon's experience and knowledge of modern techniques directly influence treatment success and recurrence rates.

Total Mesorectal Excision (TME) for Rectal Cancer

Dr. Martin Schilling, MD, discusses the evolution of rectal cancer surgery. The best standard of care moved away from older techniques like Abdominal Perineal Resection (APR) to Total Mesorectal Excision (TME). This nerve-sparing method, developed from concepts described over a century ago and popularized by surgeons like Dr. R.J. Heald, involves resecting all tissue surrounding the rectum within its anatomical plane. TME surgery removes the tumor, lymph nodes, and lymphatic vessels while meticulously preserving vital pelvic nerves.

Benefits and Outcomes of TME Surgery

The adoption of Total Mesorectal Excision has led to a dramatic improvement in rectal cancer outcomes. Dr. Martin Schilling, MD, highlights that following these precise anatomical planes reduced the local recurrence rate after five years from approximately 30% to just 5-7%. This tremendous success in local tumor control is a cornerstone of modern rectal cancer treatment, significantly improving survival and quality of life by preserving nerve function.

Mesocolic Excision for Colon Cancer

Dr. Martin Schilling, MD, explains how the principles of TME were successfully applied to colon cancer surgery. Since the mid-1990s, surgeons have performed Total Mesocolic Excision (TME's counterpart for the colon) by following the same clear mesocolic anatomical planes. This technique involves dissecting the colon cancer tumor along these defined planes. Dr. Schilling reports that using mesocolic excision has provided tremendous success in local control for colon cancer, dramatically decreasing local recurrence rates.

The Critical Importance of Primary Surgical Strategy

Both Dr. Anton Titov, MD, and Dr. Martin Schilling, MD, agree that defining the primary surgical strategy is a crucial first step. The initial operation to remove the colorectal cancer tumor is paramount for achieving long-term survival. A well-executed resection based on anatomical planes is the foundation upon which all other treatments, like chemotherapy, are built. This underscores why seeking care from a highly specialized surgeon is essential.

The Role of a Medical Second Opinion

Dr. Anton Titov, MD, and Dr. Martin Schilling, MD, emphasize the value of a medical second opinion, particularly for complex cases like stage 3 colorectal cancer. A second opinion from a leading expert can clarify the diagnosis and help determine if surgery is a viable option. For advanced disease, such as stage 3 colon cancer with liver metastases, a second opinion ensures a patient is confident they are receiving the best possible treatment plan from a top-tier center.

Full Transcript

Leading gastrointestinal cancer surgeon discusses rectal cancer and colon cancer tumor resection. The surgeon is the most important prognostic factor in cancer treatment. Correct surgical operation makes the largest impact on long-term survival of patients with colon cancer or rectal cancer.

Dr. Anton Titov, MD: Colon cancer surgery options. Best treatment method. Colon cancer and rectal cancer best surgical treatment method. Colon cancer treatment must follow mesocolic anatomical planes. Total Mesorectal Excision has been developed for rectal cancer treatment. Best surgery method for colon cancer treatment to prevent metastases and local recurrence. Total Mesocolic Excision reduces local recurrence for colon cancer from 30% to 5%. The surgeon is the most important prognostic factor in colon cancer treatment.

Medical second opinion clarifies stage 3 colorectal cancer diagnosis. Medical second opinion helps to decide if surgery is possible in stage 3 colon cancer. Best treatment for advanced stage 3 colon cancer. Medical second opinion from leading expert helps to find the best treatment for stage 3 colorectal cancer with liver metastases. Get medical second opinion on advanced colorectal cancer and be confident that your treatment is the best. Best colorectal cancer treatment center.

Video interview with leading surgeon in gastrointestinal cancer treatment surgery. What is the best colon cancer and rectal cancer surgical treatment method today? Why is it important for surgeon to know the best surgery technique for colorectal cancer treatment?

The surgeon is the most important prognostic factor in cancer treatment. Correct surgical operation makes the largest impact on long-term survival of patients with colon cancer or rectal cancer. Colon cancer surgery options. Best treatment method.

Dr. Anton Titov, MD: Rectal cancer treatment for a long time included APR, Abdominal Perineal Resection. But the best standards for rectal cancer surgery changed. You have a very large experience with the nerve-sparing method of rectal cancer treatment, Total Mesorectal Excision. Could you please talk about Total Mesorectal Excision method of rectal cancer treatment? How beneficial is TME for rectal cancer surgical treatment?

Dr. Martin Schilling, MD: Description of the mesorectal planes, the sheaths covering the rectum, has been described by Dr. W.E. Miles over a hundred years ago in 1908. Then concept of mesorectal surgical planes was applied to rectal dissection by German surgeon working in Bonn. Then it was rediscovered by Dr. R.J. Heald from the UK. Dr. Heald applied mesorectal planes concept to rectal cancer surgery around the world. Dr. Heald also made this total mesorectal excision technique to treat rectal cancer popular in the United States.

TME technique includes resection of all tissues surrounding the rectum, including lymph nodes and small lymphatic vessels. Total mesorectal excision treatment for rectal cancer preserves all vital pelvic nerves going down to the pelvic organs. Total mesorectal excision technique was used in rectal cancer surgery. Then the local recurrence rate after 5 years for rectal cancer decreased from 30% to 5% or 7%.

Following anatomical planes in TME surgery technique has had tremendous success in rectal cancer treatment. Since mid-1990s I have used similar technique in colon cancer treatment. We follow the same mesocolic anatomical planes along the colon. We dissect colon cancer tumor. Mesocolic anatomic planes are clearly described. They are similar to mesorectal anatomical planes.

Using mesocolic excision in colon cancer surgery treatment is good. It has given us tremendous success in local control in colon cancer. Local recurrence rates for colon cancer has decreased dramatically.

Dr. Anton Titov, MD: The surgeon's experience and knowledge of the best modern surgical techniques is important. It is a major prognostic factor in cancer treatment, including colorectal cancer treatment.

Dr. Martin Schilling, MD: That's correct. That's the first and one of the most important steps in successful colorectal cancer treatment. The primary operation to remove colorectal cancer tumor is crucial for long term survival of patient. It is crucial to define well the primary surgical strategy.

Dr. Anton Titov, MD: Colon cancer surgery options - best treatment method explained by leading colorectal cancer surgeon from Switzerland. Total Mesorectal excision and Mesocolic Excision.