Total Mesorectal Excision in the Treatment of Rectal Cancer: a Review

Abstract

Despite the improvements in preoperative staging, surgical technique and adjuvant therapy, local recurrence remains a significant problem in rectal cancer surgery.

Several patient- and tumour-related risk factors for the development of local recurrence have been identified and are being addressed by regimens of pre- or postoperative adjuvant therapy.

Total mesorectal excision (TME) recently has been shown to result in a low recurrence rate even without the use of adjuvant therapy. Nevertheless, conclusive evidence in the form of a prospective randomized trial is to date not available.

This paper describes the technique of TME and reviews the clinical and pathological data supporting its use in rectal cancer surgery.

Key words:

• Rectal cancer
• mesorectum
• surgery
• therapy