[Introduction of a new surgical technique in rectal cancer]

Local recurrence rates following surgery for rectal cancer show considerable variation in different series, but impressive results (< 4% local recurrences after five years) have been presented by surgeons using total mesorectal excision as their operative technique. In Norway, local recurrence rates of 30% have been reported. Total mesorectal excision was introduced at Ullevaal Hospital in January, 1994 following a specific training programme. To enable us to compare the results, we followed-up two groups of patients who had undergone surgery for rectal carcinoma; one group (76 patients) before the introduction of total mesorectal excision and the other (76 patients) after total mesorectal excision was introduced. Anastomotic leakages were the main problem in the initial phase, but after faecal diversion became routine only one leakage was observed. After a median observation time of 28 months we had observed two patients (4.3%) with local recurrence in the total mesorectal excision group, and ten (23.8%) in the group where total mesorectal excision had not been performed.