Effect of the introduction of total mesorectal excision for the treatment of rectal cancer

Carlsen, Erik; Schlichting, Ellen; Guldvog, I; Johnson, Egil; Heald, R. J.

doi:10.1046/j.1365-2168.1998.00601.x

Cited by 276 publications

(195 citation statements)

References 15 publications

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“…The introduction of TME surgery can be associated initially with higher rates of anastomotic leakage, but several studies showed that these findings would improve during the routine application of TME surgery [21-23]. During the time of our study there were 4 of 78 cases with a clinical apparent anastomotic leakage.…”

Section: Discussionmentioning

confidence: 83%

TME quality in rectal cancer surgery

et al. 2010

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Background The concept of total mesorectal excision has revolutionised rectal cancer surgery. TME reduces the rate of local recurrence and tumour associated mortality. However, in clinical trials only 50% of the removed rectal tumours have an optimal TME quality. Patients: During a period of 36 months we performed 103 rectal resections. The majority of patients (76%; 78/103) received an anterior resection. The remaining patients underwent either abdominoperineal resection (16%; 17/103), Hartmann's procedure (6%; 6/103) or colectomy (2%; 2/103). Results In 90% (93/103) TME quality control could be performed. 99% (92/93) of resected tumours had optimal TME quality. In 1% (1/93) the mesorectum was nearly complete. None of the removed tumours had an incomplete mesorectum. In 98% (91/93) the circumferential resection margin was negative. Major surgical complications occurred in 17% (18/103). 5% (4/78) of patients with anterior resection had anastomotic leakage. 17% (17/103) developed wound infections. Mortality after elective surgery was 4% (4/95). Conclusion Optimal TME quality results can be achieved in all stages of rectal cancer with a rate of morbidity and mortality comparable to the results from the literature. Future studies should evaluate outcome and local recurrence in accordance to the degree of TME quality.

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Section: Discussionmentioning

confidence: 83%

TME quality in rectal cancer surgery

et al. 2010

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“…These differences of recurrence rates may be explained by retrospective design of the majority of the studies and the heterogeneity of the patient groups. There are some publications that suggest that total mesorectal excision is the surgical technique with the lowest rate of local recurrence (Enker et al, 1995;Arbman et al, 1996;Heald et al, 1998;Carlsen et al, 1998;Havenga et al, 1999;Leo et al, 2000). Prospective studies for adjuvant therapy in the group with Stage I rectal cancer are limited (Steele et al,1999;Russell et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

Recurrence Risk and Prognostic Parameters in Stage I Rectal Cancers

Cihan

Küçüköner²,

Özdemir³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…Comparisons before and after training workshops in Norway in the early 1990's in the TME technique documented LRR rates that decreased from 16% to 8% [8]. Likewise, a systematic training program established in Stockholm from 1994 to 1995 changed the definitive surgical procedure from non-TME resection to TME resection and LRR decreased from 15% to 6% with surgery alone [9].…”

Section: Total Mesorectal Excision Decreases Local Recurrencementioning

confidence: 99%

The Changing Role of Radiation in the Post-TME ERA of Rectal Cancer

Lai¹,

Thomas²

2010

CCTR

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Total mesorectal excision (TME) for rectal cancer is now considered standard in the surgical treatment of rectal cancer. The application of this technique has resulted in a pooled pelvic recurrence rate of approximately 7%. Preoperative and postoperative radiation further decreases the local regional recurrence (LRR) rate in patients with rectal cancer but the reduction in risk is counterbalanced by increased short and long term toxicity. Lower LRR rates have not uniformly translated into more favorable overall survival. In addition, advances in imaging have resulted in more accurate pretreatment staging and have improved the ability to stratify patients based on risk of recurrence. Given low pelvic recurrence rates after TME-based surgery alone, the risks and toxicities of pelvic radiation, and superior imaging to select high risk patients, radiation may not be requisite in the treatment of all rectal cancer patients. In this review, we discuss the current status of radiation and LRR rates in rectal cancer after definitive surgical resection with respect to specific subsites and stages of disease, examine the impact of imaging in the selection of patients for radiation, and raise the possibility that predictive biomarkers may help to identify patients who may not require pelvic radiation.

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Effect of the introduction of total mesorectal excision for the treatment of rectal cancer

Abstract: Anastomotic dehiscence increased after introduction of the TME technique but this improved with experience.

Cited by 276 publications

References 15 publications

TME quality in rectal cancer surgery

TME quality in rectal cancer surgery

Recurrence Risk and Prognostic Parameters in Stage I Rectal Cancers

The Changing Role of Radiation in the Post-TME ERA of Rectal Cancer

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