title: TME quality in rectal cancer surgery.
abstract: BACKGROUND
  The concept of total mesorectal excision has revolutionised rectal cancer surgery. TME reduces the rate of local recurrence and tumour associated mortality. However, in clinical trials only 50% of the removed rectal tumours have an optimal TME quality.
  
  
  METHODS
  During a period of 36 months we performed 103 rectal resections. The majority of patients (76%; 78/103) received an anterior resection. The remaining patients underwent either abdominoperineal resection (16%; 17/103), Hartmann;s procedure (6%; 6/103) or colectomy (2%; 2/103).
  
  
  RESULTS
  In 90% (93/103) TME quality control could be performed. 99% (92/93) of resected tumours had optimal TME quality. In 1% (1/93) the mesorectum was nearly complete. None of the removed tumours had an incomplete mesorectum. In 98% (91/93) the circumferential resection margin was negative. Major surgical complications occurred in 17% (18/103). 5% (4/78) of patients with anterior resection had anastomotic leakage. 17% (17/103) developed wound infections. Mortality after elective surgery was 4% (4/95).
  
  
  CONCLUSIONS
  Optimal TME quality results can be achieved in all stages of rectal cancer with a rate of morbidity and mortality comparable to the results from the literature. Future studies should evaluate outcome and local recurrence in accordance to the degree of TME quality.
authors.affiliation: Department of Surgery, St. Josef Hospital, Ruhr-university Bochum, School of Medicine, germany.
authors.forename: T
authors.initials: T
authors.lastname: Herzog
authors.forename: O
authors.initials: O
authors.lastname: Belyaev
authors.forename: A M
authors.initials: AM
authors.lastname: Chromik
authors.forename: D
authors.initials: D
authors.lastname: Weyhe
authors.forename: C A
authors.initials: CA
authors.lastname: Mueller
authors.forename: J
authors.initials: J
authors.lastname: Munding
authors.forename: A
authors.initials: A
authors.lastname: Tannapfel
authors.forename: W
authors.initials: W
authors.lastname: Uhl
authors.forename: Matthias H
authors.initials: MH
authors.lastname: Seelig
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D013505:Digestive System Surgical Procedures / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011786:Quality Control; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*