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Related Experiment Video

Updated: Jul 15, 2025

Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
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Completion Total Mesorectal Excision: A Case-Matched Comparison With Primary Resection.

Thijs A Burghgraef1,2, Marieke L Rutgers3, Jeroen W A Leijtens4

  • 1From the Department of Surgery, Meander Medical Centre, Amersfoort, the Netherlands.

Annals of Surgery Open : Perspectives of Surgical History, Education, and Clinical Approaches
|September 25, 2023
PubMed
Summary
This summary is machine-generated.

Completion total mesorectal excision (cTME) for rectal cancer shows similar oncological outcomes and morbidity compared to primary total mesorectal excision (pTME). Local excision followed by cTME is a viable treatment for early rectal cancer.

Keywords:
rectal cancersurgerytotal mesorectal excision

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Area of Science:

  • Colorectal Surgery
  • Surgical Oncology
  • Rectal Cancer Treatment

Background:

  • Early-stage rectal cancer can be managed with local excision, offering reduced morbidity and better functional outcomes than radical surgery.
  • Completion total mesorectal excision (cTME) is indicated for high-risk features post-local excision, but its outcomes relative to primary total mesorectal excision (pTME) require comparison.

Purpose of the Study:

  • To compare perioperative and oncological results of completion total mesorectal excision (cTME) versus primary total mesorectal excision (pTME).

Main Methods:

  • Retrospective cohort study of rectal cancer patients undergoing TME surgery across 11 Dutch centers (2015-2017).
  • Case-matched comparison of cTME (n=29) and pTME (n=58) groups.
  • Primary outcome: major postoperative morbidity. Secondary outcomes: restorative procedure rates and 3-year oncological outcomes.

Main Results:

  • No significant differences in major morbidity (27.6% vs 19.0%; P=0.28) or abdominoperineal excision rates (31.0% vs 32.8%; P=0.85) between cTME and pTME.
  • Comparable 3-year oncological outcomes: local recurrence (3.4% vs 8.6%), systemic recurrence (3.4% vs 12.1%), overall survival (93.1% vs 94.8%), and disease-free survival (89.7% vs 81.0%).

Conclusions:

  • Completion total mesorectal excision (cTME) does not increase major morbidity and yields similar oncological outcomes to primary total mesorectal excision (pTME).
  • Local excision followed by cTME is a safe and effective approach for early-stage rectal cancer, maintaining comparable outcomes to pTME.