title: Total mesorectal excision: what are we doing?
abstract: The introduction of total mesorectal excision (TME) for rectal cancer has reduced local recurrence rates and improved oncologic outcomes, although complication rates such as anastomotic leak have also been a consequence. With the advent of neoadjuvant therapy for rectal cancer, many are questioning how this development may change the role of TME. This review presents a history of how TME evolved and a description of this technique. Complication rates, the impact of neoadjuvant therapy on local recurrence, variations of TME such as nerve-sparing proctectomy and cancer-specific mesorectal excision, and a review of functional outcomes for various methods of reconstruction are presented.
authors.affiliation: Division of Surgery, Washington University School of Medicine, Barnes-Jewish-Christian Hospital, St. Louis, MO 63110, USA.
authors.forename: David B
authors.initials: DB
authors.lastname: Stewart
authors.forename: David W
authors.initials: DW
authors.lastname: Dietz