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Published on: February 12, 2022
TME quality in rectal cancer surgery
T Herzog1, O Belyaev, A M Chromik
1Department of Surgery, St. Josef Hospital, Ruhr-university Bochum, School of Medicine, germany.
European Journal of Medical Research
|August 11, 2010
Summary
High-quality total mesorectal excision (TME) is achievable in rectal cancer surgery, leading to excellent outcomes. This study demonstrates that optimal TME quality can be consistently obtained, comparable to literature benchmarks.
Area of Science:
- Colorectal Surgery
- Surgical Oncology
- Oncology
Background:
- Total mesorectal excision (TME) has significantly improved outcomes in rectal cancer surgery by reducing local recurrence and mortality.
- However, suboptimal TME quality is frequently reported in clinical trials, achieving optimal quality in only 50% of cases.
Purpose of the Study:
- To evaluate the feasibility and outcomes of achieving optimal total mesorectal excision (TME) quality in a real-world clinical setting.
- To assess the rates of surgical complications and mortality associated with high-quality TME in rectal cancer resections.
Main Methods:
- A retrospective analysis of 103 rectal resections performed over 36 months.
- Procedures included anterior resection (76%), abdominoperineal resection (16%), Hartmann's procedure (6%), and colectomy (2%).
- TME quality control was performed on 90% of resections, assessing mesorectal completeness and circumferential resection margin.
Main Results:
- Optimal TME quality was achieved in 99% of resected tumors where quality control was possible (92/93).
- A negative circumferential resection margin was achieved in 98% (91/93) of cases.
- Major surgical complications occurred in 17% (18/103), with anastomotic leakage in 5% of anterior resections and wound infections in 17%.
Conclusions:
- Consistently achieving optimal total mesorectal excision (TME) quality is feasible across all rectal cancer stages.
- Morbidity and mortality rates associated with high-quality TME are comparable to existing literature.
- Further research should correlate TME quality with patient outcomes and local recurrence rates.
