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The appropriateness of this \u2018one\u2010size\u2010fits\u2010all\u2019 strategy is questioned as bowel cancer screening programmes result in a shift to earlier stage disease. Currently, the nodal status of a colorectal cancer can only be reliably determined by histopathological examination of the resected specimen. New methods of intra\u2010operative staging are required to allow surgical resection to be tailored to the stage of the disease.<\/jats:p><jats:p><jats:bold>Method\u2002<\/jats:bold> A literature search was performed of PubMed and Embase databases using the terms \u2018colon\u2019 OR \u2018colorectal\u2019 AND \u2018intra\u2010operative detection\u2019 OR \u2018intra\u2010operative staging\u2019 OR \u2018intra\u2010operative detection\u2019 OR \u2018radioimmunoguided surgery\u2019. Articles published between January 1980 and January 2012 were included. Technologies that have the potential to allow intra\u2010operative staging and treatment stratification were identified and further searches performed.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> Established techniques such as sentinel lymph node mapping and radioimmunoguided surgery have benefited from combination with other technologies to allow real\u2010time intra\u2010operative staging. Intra\u2010operative fluorescence, using naturally fluorescent biomarkers or fluorescent tumour probes, probably offers the most practical means of intra\u2010operative lymph node staging and may be facilitated using nanotechnology. Optical coherence tomography and real\u2010time elastography have the potential to provide an <jats:italic>in vivo<\/jats:italic>\u2018virtual biopsy\u2019.<\/jats:p><jats:p><jats:bold>Conclusion\u2002<\/jats:bold> Technological advances may allow accurate intra\u2010operative lymph node staging to facilitate tailored surgical resection. This may become the next paradigm shift in colorectal cancer surgery.<\/jats:p>","DOI":"10.1111\/j.1463-1318.2012.03078.x","type":"journal-article","created":{"date-parts":[[2012,5,7]],"date-time":"2012-05-07T16:43:58Z","timestamp":1336409038000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Intra\u2010operative tumour detection and staging in colorectal cancer surgery"],"prefix":"10.1111","volume":"14","author":[{"given":"J. P.","family":"Tiernan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Ansari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. A.","family":"Hirst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. 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