Emphasis on the application of basic concepts in oncological surgery and their evolution over time

Colorectal oncology surgery has evolved from traditional open surgery to robotic-assisted minimally invasive surgery over a century. Amidst technological innovations, rational evaluation and inheritance of classic oncological surgical concepts have become critical. The author systematically discusses the evolution of traditional principles, including the "no touch technique" "high ligation of tumor‑feeding vessels" "safety margin" and "radical lymph node dissection" based on evidence‑based medicine and clinical practice. While the "no touch technique" was once a cornerstone in open surgery, multiple randomized controlled trials and Meta‑analyses have shown no significant difference in long‑term survival between this technique and conventional methods in laparoscopic and robotic surgery, suggesting the need for objective reassessment of its modern clinical relevance. Regarding high ligation of the inferior mesenteric artery, recent studies have demonstrated no survival benefit for most patients, while low ligation with preservation of the left colic artery reduces constipation rates. Combined with the intrafascial nerve‑sparing technique, urogenital dysfunction can be further minimized. The safety margin for rectal cancer is shifting from empirical to precision medicine. The popularity of neoadjuvant therapy has allowed distal margins to be shortened to 1-2 cm, with 0.5-1.0 cm acceptable in some cases, though individualization based on tumor genotyping is essential. Radical lymph node dissection (e.g., No.253 lymph nodes) has transitioned from extended radical resection to a personalized strategy, recommended only for patients with preoperative imaging suspicion of metastasis to avoid overtreatment. The author emphasizes that young surgeons must inherit the core values of classic concepts (e.g., oncological radical resection, anatomical precision) while leveraging evidence‑based medicine, minimally invasive techniques, and molecular profiling to drive innovation and optimization. Only through the dialectical unity of tradition and innovation can colorectal oncology surgery achieve precision and humaniza-tion, ultimately improving patient outcomes and quality of life.