Concept
colorectal surgery
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Margin-Driven Colorectal Oncology
1951 - 1957
The period emphasized margin-driven strategies and radical resections to minimize local recurrence, guided by mechanistic insights into tumor implantation at suture lines and the value of planned distal and proximal margins. A transition toward sphincter-sparing rectal cancer surgery sought functional preservation, accompanied by standardized dissection extents across pelvic resections. Growing attention to polyps as precursors and their malignant potential informed pathologic characterization, screening concepts, and management considerations.
• Recurrence suppression and mechanistic understanding of local recurrence after colorectal cancer surgery, emphasizing possible tumor implantation at suture lines and the importance of margins and radical resections to reduce recurrence [2], [5], [6], [1], [20], [19].
• Polyps as critical cancer precursors: historical studies unify observations on adenomatous polyps, polyps’ malignant potential, and implications for screening, pathologic characterization, and management [4], [3], [14], [15], [16], [17], [11].
• Sphincter-preserving rectal cancer surgery and standardization: a shift from permanent colostomy to sphincter-sparing operations with planned dissection extent, contributing to functional outcomes and technique standardization [1], [10], [13], [18].
• Margins and dissection planning in pelvic colon and rectal cancer: analysis of distal/proximal margins and proximal extent standardization to minimize residual disease and recurrences across multiple surgical approaches [20], [19], [18], [13].
Adenoma-Carcinoma Paradigm
1958 - 1964
Primary Anastomosis Paradigm
1965 - 1973
Screening-Driven Oncologic Resection
1974 - 1980
Total Mesorectal Excision Paradigm
1981 - 1987
Total Mesorectal Excision Standardization
1988 - 1995
Laparoscopic Colorectal Era
1996 - 2002
Laparoscopic Colorectal Surgery Paradigm
2003 - 2009
Minimally Invasive Colorectal Paradigm
2010 - 2016
Perfusion-Guided Colorectal Surgery
2017 - 2023