Total mesorectal excision for surgical treatment of rectal cancer

Abstract

Background and Objectives:The aim of our study was to retrospectively evaluate the results of 2 groups of patients admitted and treated for rectal cancer. Methods: One hundred and fifty-one patients were available for evaluation. Eighty (group A) were radically operated with the standard technique; 71 (group B) underwent total mesorectal excision (TME). Groups were similar according to demographics, staging, and pathological data. Mean follow-up was 73.5 months. Results: No operative mortality was observed. Complications were 15% in group A and 32% in group B. Local recurrence rates were 41.2% in group A and 12.6% in group B. Distant metastases occurred in 21.2% and 7.6%, respectively, in groups A and B. Cancer-related mortality was 62.5% in the non-TME group and 19.5% in the TME group. Overall 5-year survival rates were 32.4% in group A and 70.5% in group B. Disease-free survival rates were 25% in group A and 62.3% in group B.Conclusions: TME appears to lower the incidence of cancer-related mortality, with a higher incidence of postoperative complications. Further studies need to be done to assess the real benefits of TME in the surgical treatment of rectal cancer.

Surgical specialization and training – its relation to clinical outcome for colorectal cancer surgery

“…Bolognese et al . compared results in a single Italian hospital before and after TME and concluded that higher incidence of postoperative anastomotic leak is offset by reduced incidence of cancer‐related 5‐year mortality (from 62% to 20%) after TME [48]. Garcia‐Granero et al .…”

Total Mesorectal Excision, Lateral Lymphadenectomy and Autonomic Nerve Preservation for Lower Rectal Cancer: Significance in the Long-term Follow-up Study.

“…Uncontrollable massive bleeding often happened. We must pay attention to the high mortality rate after CVS, as reported by Bolognese [36]. Overall LLA seems to be as safe as THE for most rectal cancer patients, at least for Japanese patients.…”

Prospective evaluation of a colorectal cancer nurse follow‐up clinic

“…The 5‐year survival is reported to be 50% [22]. Recurrence rates reported by different groups vary widely, from 4 to 40% at 5 years [23–25]. At the time of writing, the follow‐up period of our study had not reached a minimum of 5 years for all patients and therefore we were unable to express strong views on the long‐term survival benefits of our protocols; however, this was not the aim of the current study.…”