Abstract
In 1982 Heald et al. described total mesorectal excision (TME) in a paper from Basingstoke (UK) entitled “The mesorectum in rectal cancer surgery—the clue to pelvic recurrence?”. The four-year follow-up data reported a 3.7% local recurrence rate. This, and subsequent data, gave rises to a large-scale initiative to train all Swedish rectal cancer surgeons in the TME technique. The result was a fall in 5-year local recurrence from 14 to 6% with an associated improvement in survival. This chapter outlines the practical details provided during that training and it is intended to offer the necessary details to perform optimal TME surgery.
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References
Heald RJ, Husband EM, Ryall RDH. The mesorectum in rectal cancer surgery—the clue to pelvic recurrence? Br J Surg. 1982;69(10):613–6.
Heald RJ, Ryall RD. Recurrence and survival after total mesorectal excision for rectal cancer. Lancet. 1986;1(8496):1479–82.
Arbman G, Nilsson E, Hallböök O, Sjödahl R. Local recurrence following total mesorectal excision for rectal cancer. Br J Surg. 1996;83(3):375–9.
Enker WE, Thaler HT, Cranor ML, Polyak T. Total mesorectal excision in the operative treatment of carcinoma of the rectum. J Am Coll Surg. 1995;181(4):335–46.
Bjerkeset T, Edna TH. Rectal cancer: the influence of type of operation on local recurrence and survival. Eur J Surg. 1996;162(8):643–8.
Martling AL, Holm T, Rutqvist LE, Moran BJ, Heald RJ, Cedemark B. Effect of a surgical training programme on outcome of rectal cancer in the County of Stockholm. Stockholm Colorectal Cancer Study Group, Basingstoke Bowel Cancer Research Project. Lancet. 2000;356(9224):93–6.
Moran BJ, Holm T, Branagan G, Chave H, Quirke P, West N, et al. The English national low rectal cancer development programme: key messages and future perspectives. Color Dis. 2014;16(3):173–8.
Battersby NJ, How P, Moran B, Stelzner S, West NP, Branagan G, et al. Prospective validation of a low rectal cancer magnetic resonance imaging staging system and development of a local recurrence risk stratification model: the MERCURY II study. Ann Surg. 2016;263(4):751–60.
Moran B. Chapter 7: Total mesorectal excision for rectal cancer. In: Moran B, Heald RJ, editors. Manual of total mesorectal excision. Boca Raton, FL: CRC Press; 2013. p. 103–23.
Walsh PC, Schlegel PN. Radical pelvic surgery with preservation of sexual function. Ann Surg. 1988;208(4):391–400.
Moran BJ. Stapling instruments for intestinal anastomosis in colorectal surgery. Br J Surg. 1996;83(7):902–9.
Lewis WG, Martin IG, Williamson ME, Stephenson BM, Holdsworth PJ, Finan PJ, et al. Why do some patients experience poor functional results after anterior resection of the rectum for carcinoma? Dis Colon Rectum. 1995;38(3):259–63.
Matthiessen P, Hallböök O, Rutegård J, Simert G, Sjödahl R. Defunctioning stoma reduces symptomatic anastomotic leakage after low anterior resection of the rectum for cancer: a randomized multicenter trial. Ann Surg. 2007;246(2):207–14.
Hüser N, Michalski CW, Erkan M, Schuster T, Rosenberg R, Kleeff J, et al. Systematic review and meta-analysis of the role of defunctioning stoma in low rectal cancer surgery. Ann Surg. 2008;248(1):52–60.
David GG, Slavin JP, Willmott S, Corless DJ, Khan AU, Selvasekar CR. Loop ileostomy following anterior resection: is it really temporary? Color Dis. 2010;12(5):428–32.
Adam IJ, Mohamdee MO, Martin IG, Scott N, Finan PJ, Johnston D, et al. Role of circumferential margin involvement in the local recurrence of rectal cancer. Lancet. 1994;344(8924):707–11.
Nagtegaal ID, Quirke P. What is the role for the circumferential margin in the modern treatment of rectal cancer? J Clin Oncol. 2008;26(2):303–12.
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Battersby, N.J., Moran, B. (2021). Rectal Cancer: Anterior Resection and Low Anterior Resection with Total or Partial Mesorectal Excision. In: Hohenberger, W., Parker, M. (eds) Lower Gastrointestinal Tract Surgery. Springer Surgery Atlas Series. Springer, Cham. https://doi.org/10.1007/978-3-030-60827-9_12
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DOI: https://doi.org/10.1007/978-3-030-60827-9_12
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