TME quality in rectal cancer surgery.
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.
Herzog
T
T
Department of Surgery, St. Josef Hospital, Ruhr-university Bochum, School of Medicine, germany.
Belyaev
O
O
Chromik
A M
AM
Weyhe
D
D
Mueller
C A
CA
Munding
J
J
Tannapfel
A
A
Uhl
W
W
Seelig
Matthias H
MH
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*