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Clin Colon Rectal Surg 2002; 15(1): 027-034
DOI: 10.1055/s-2002-23565
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Total Mesorectal Excision in Rectal Cancer Resection

Harvey G. Moore1 , Jose G. Guillem1, 2
  • 1Colorectal Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY
  • 2Cornell University Medical College, New York, NY
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Publication History

Publication Date:
03 April 2002 (online)

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ABSTRACT

Despite the routine use of adjuvant chemoradiation for Stages II-III curatively resected rectal cancer, a significant percentage of patients ultimately fail locally and/or distally. Recognition of the importance of lateral, or circumferential, margins of resection has changed the surgeon's approach to oncologic resection of the rectum. The concept of total mesorectal excision (TME) is based upon the principle of resecting as an intact unit the rectum together with its lymphovascular drainage contained within the fascia propria. The widespread use of TME has been associated with a reduction in the incidence of local recurrence in large clinical series in the United States and Europe, thereby calling into question traditional indications for adjuvant therapy. Current efforts are directed at further defining the pattern of rectal cancer spread and identifying the subset of locally advanced rectal cancer patients that may be treated with a TME rectal cancer resection alone.

KEYWORD

Total mesorectal excision - rectal neoplasms - autonomic nerve preservation

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