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Updated: Jun 17, 2026

Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
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Total mesorectal excision: what are we doing?

David B Stewart1, David W Dietz

  • 1Division of Surgery, Washington University School of Medicine, Barnes-Jewish-Christian Hospital, St. Louis, MO 63110, USA.

Clinics in Colon and Rectal Surgery
|December 17, 2009
PubMed
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Total mesorectal excision (TME) improves rectal cancer outcomes but has complications. Neoadjuvant therapy

Area of Science:

  • Colorectal Surgery
  • Surgical Oncology
  • Rectal Cancer Treatment

Background:

  • Total mesorectal excision (TME) is a standard surgical technique for rectal cancer.
  • TME has significantly reduced local recurrence rates and improved oncologic outcomes.
  • Complications, such as anastomotic leak, can occur following TME.

Purpose of the Study:

  • To review the evolution and techniques of TME in rectal cancer surgery.
  • To assess the impact of neoadjuvant therapy on TME's role and outcomes.
  • To discuss TME variations, complications, and functional outcomes.

Main Methods:

  • Literature review of TME evolution, techniques, and outcomes.
  • Analysis of neoadjuvant therapy's influence on TME and recurrence rates.
Keywords:
Total mesorectal excisionrectal cancerrecurrencereview articlesurgical technique

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  • Review of TME variations, including nerve-sparing and cancer-specific approaches.
  • Evaluation of functional outcomes associated with different reconstruction methods.

    • Main Results:

    • TME has historically improved rectal cancer outcomes.
    • Neoadjuvant therapy is altering the landscape and role of TME.
    • Variations of TME and reconstruction techniques impact patient outcomes and complications.

    Conclusions:

    • TME remains a cornerstone of rectal cancer treatment.
    • The integration of neoadjuvant therapy necessitates a re-evaluation of TME protocols.
    • Further research into TME variations and functional outcomes is crucial for optimizing patient care.