Összefoglaló cikkünkben a colon- és rectumcarcinomák sebészeti kezelésében az elmúlt években megjelent új elveket, új ötleteket és technológiákat tekintjük át. A tanulmány narratív összefoglalás, mely tematikusan kiemelt colorectalis sebészeti irodalmi ismeretek gyűjteményét adja két, a colorectalis sebészetben jártas sebész független válogatása alapján. A coloncarcinomák esetében a komplett mesocolon-excisiót (CME), illetve a radikális lymphadenectomiát, a jobb és bal colonfél tumorainak biológiai eltéréseit, valamint a tumorbiológiai jellemzők alapján a neoadjuváns gyógyszeres kezelés lehetőségeit értékeljük. A rectumcarcinomák sebészeti megoldásai közül a transanalis teljes mesorectum-excisio (TaTME), a robotsebészet, az intersphinctericus reszekciók, illetve a lymphadenectomia radikalitásának kérdései, végül a szervkímélő rectumsebészet kerül tárgyalásra. A colon- és a rectumcarcinoma sebészete mára jelentősen eltérő utakra jutott. A technikai, technológiai innováció nyújtotta lehetőségeket a patológiai, onkológiai ismeretekkel összhangban személyre szabott terápiás lehetőségekként indokolt a mindennapokban multidiszciplináris döntés alapján alkalmazni. Orv Hetil. 2024; 165(2): 43–50.
In this review, we summarize the new principles, new ideas and new techniques that have emerged in recent years in the surgical treatment of colon and rectal carcinomas. The paper is a narrative summary, providing a collection of the most recent relevant literature on thematically highlighted aspects of colorectal surgery, based on an independent selection of two surgeons experienced in colorectal surgery. Complete mesocolic excision (CME) and radical lymphadenectomy for colorectal carcinomas, biological differences between right and left colon tumors, and the options for neoadjuvant drug treatment based on tumor biology are evaluated. In the context of rectal cancer, the issues of transanal total mesorectal excision (TaTME), robotic surgery, intersphincteric resections and radicality of lymphadenectomy will be discussed, and finally the principle of organ-sparing rectal surgery will be evaluated. Colon and rectal carcinoma surgery have now taken significantly different paths. Technical and technological innovations must be adapted to the pathological and oncological knowledge and adapted to the daily practice as personalized therapeutic options based on a multidisciplinary team decision. Orv Hetil. 2024; 165(2): 43–50.
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