ABSTRACT
Throughout the world, there are guidelines for the surgical management of colonic cancer, yet there are significant differences in reported five-year survival rates that vary in stage III disease between 44 and 85 percent. The explanation for such differences is multi-factorial, however one important element is the quality of surgical excision. Inadequate surgical technique leads to an inadequate resection specimen that may include the tumor but not the mesenteric package surrounding the tumor with preservation of the mesocolic planes of dissection including all potentially involved lymph nodes. These principles are respected in the technique of total mesocolic excision described by the author.
