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Related Experiment Video

Updated: Jun 28, 2026

Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
12:45

Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer

Published on: February 12, 2022

Upfront Total Mesorectal Excision for MRI-Defined Low-Risk cT3 Rectal Cancer: A Systematic Review and Meta-Analysis.

Bernardo Fontel Pompeu1,2, Camila Haddad Baptista1, Thais Henriques Abud1

  • 1Department of Colorectal Surgery, Heliopolis Hospital, São Paulo, Brazil.

The American Surgeon
|June 26, 2026
PubMed
Summary

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For MRI-defined low-risk cT3 rectal cancer, upfront surgery offers similar oncologic outcomes to neoadjuvant therapy but with shorter operative times. However, current evidence is insufficient for definitive treatment recommendations.

Area of Science:

  • Oncology
  • Surgical Oncology
  • Radiology

Background:

  • Contemporary rectal cancer management utilizes MRI-based risk stratification for cT3 tumors.
  • Low-risk cT3 rectal tumors are candidates for potentially avoiding neoadjuvant therapy.
  • This meta-analysis evaluates upfront surgery versus neoadjuvant therapy in this specific patient group.

Purpose of the Study:

  • To compare upfront total mesorectal excision (TME) with neoadjuvant therapy.
  • To assess oncologic and perioperative outcomes in MRI-defined low-risk cT3 rectal cancer.

Main Methods:

  • Systematic literature search of PubMed, Scopus, and Cochrane Central up to June 2025.
  • Random-effects meta-analysis of pooled odds ratios, mean differences, and hazard ratios.
  • Complementary Bayesian meta-analysis to explore uncertainty and potential equivalence.
Keywords:
meta-analysisneoadjuvant chemoradiotherapyrectal cancertotal mesorectal excisionupfront surgery

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Caudal-to-cranial Approach in Laparoscopic Right Hemicolectomy with Complete Mesocolon Excision and D3 Lymph Node Dissection

Published on: January 9, 2026

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Last Updated: Jun 28, 2026

Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
12:45

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Published on: February 12, 2022

Caudal-to-cranial Approach in Laparoscopic Right Hemicolectomy with Complete Mesocolon Excision and D3 Lymph Node Dissection
06:46

Caudal-to-cranial Approach in Laparoscopic Right Hemicolectomy with Complete Mesocolon Excision and D3 Lymph Node Dissection

Published on: January 9, 2026

Main Results:

  • Upfront surgery demonstrated shorter operative times and increased lymph node retrieval.
  • No significant differences in perioperative complications (e.g., anastomotic leaks, reoperations).
  • Comparable oncologic outcomes: CRM positivity, local/distant recurrence, disease-free survival, and overall survival.

Conclusions:

  • Upfront TME may yield comparable oncologic outcomes to neoadjuvant therapy in low-risk cT3 rectal cancer.
  • Evidence remains exploratory and insufficient for definitive treatment guidelines.
  • Further research is needed to establish optimal management strategies.