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Lymph node dissection in rectal carcinoma: TME and what else?
Jonas Göhl1, Werner Hohenberger, Susanne Merkel
1Department of Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstrasse 12, Erlangen, Germany. jonas.goehl@uk-erlangen.de
Total mesorectal excision (TME) is standard for lower/middle rectal cancer, aiming for low recurrence and good function. Its role in upper rectal cancer remains debated, with laparoscopic TME showing no current advantage over conventional methods.
Area of Science:
- Surgical Oncology
- Gastrointestinal Surgery
- Rectal Cancer Treatment
Background:
- Total mesorectal excision (TME) is a standard surgical procedure for middle and lower rectal cancers.
- Its application in upper rectal third carcinomas is considered controversial.
- TME aims to minimize locoregional recurrences and optimize functional outcomes.
Purpose of the Study:
- To evaluate the role and efficacy of Total Mesorectal Excision (TME) in rectal cancer surgery.
- To discuss the necessity and establishment of additional lymph node dissection procedures.
- To compare laparoscopic TME with conventional TME and assess quality control.
Main Methods:
- Review of established surgical procedures for rectal cancer.
- Discussion on the relevance and approval of additional lymph node dissection techniques.
- Comparison of outcomes between laparoscopic and conventional Total Mesorectal Excision (TME).
Main Results:
- Total mesorectal excision (TME) is crucial for lymphatic dissection in lower and middle rectal carcinomas.
- Laparoscopic TME currently demonstrates no significant advantage over conventional TME.
- Pathological assessment of TME quality based on predefined criteria is essential.
Conclusions:
- Total mesorectal excision (TME) remains a cornerstone in the multimodal treatment of rectal cancer.
- Further evaluation is needed for TME in upper rectal cancers.
- Standardized pathological assessment is vital for ensuring TME quality and efficacy.
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