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Clin Colon Rectal Surg 2007; 20(3): 190-202
DOI: 10.1055/s-2007-984863
Copyright © 2007 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Total Mesorectal Excision: What Are We Doing?

David B. Stewart1 , David W. Dietz1
  • 1Section of Colon and Rectal Surgery, Division of Surgery, Washington University School of Medicine, Barnes-Jewish-Christian Hospital, St. Louis, Missouri
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Publication History

Publication Date:
31 July 2007 (online)

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ABSTRACT

The introduction of total mesorectal excision (TME) for rectal cancer has reduced local recurrence rates and improved oncologic outcomes, although complication rates such as anastomotic leak have also been a consequence. With the advent of neoadjuvant therapy for rectal cancer, many are questioning how this development may change the role of TME. This review presents a history of how TME evolved and a description of this technique. Complication rates, the impact of neoadjuvant therapy on local recurrence, variations of TME such as nerve-sparing proctectomy and cancer-specific mesorectal excision, and a review of functional outcomes for various methods of reconstruction are presented.

KEYWORDS

Total mesorectal excision - rectal cancer - recurrence - surgical technique - review article

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David W DietzM.D. 

Washington University School of Medicine

660 S. Euclid Ave., Campus Box 8109, St. Louis, MO 63110

Email: dietzd@wudosis.wustl.edu