title: Total Mesorectal Excision, an erroneous anatomical term for the gold standard in rectal cancer treatment.
abstract: In 1986 Professor R J Heald published in The Lancet his new technique which he called Total Mesorectal Excision; today this is the gold standard for the surgical management of rectal cancer. In Total Mesorectal Excision (TME), the mesorectum is the term used to describe all the peri-rectal connective tissue including the posterior sheath of the endopelvic fascia containing the peri-rectal neurovascular structures. However, the mesenterium is a defined structure composed of a double layer of peritoneum which does not include the endopelvic fascia and the lateral rectal stalks, so these should not be included in the term 'mesorectum'. In our globalized medical culture it is important to use anatomic terms approved by the International Federation of Associations of Anatomists, as contained in the Terminologia Anatomica produced by the Federative International Programme for Anatomical Terminology (FIPAT). The term mesorectum is not listed in the Terminologia Anatomica.
authors.affiliation: Residente de Segundo año Cirugía General, Hospital Angeles Mocel, México D.F Facultad Mexicana de Medicina, Universidad La Salle, México D.F., Mexico. Electronic address: rita.rodriguez.md@gmail.com.
authors.forename: María Rita
authors.initials: MR
authors.lastname: Rodríguez-Luna
authors.affiliation: Departamento de Anatomía, Facultad de Medicina, Universidad Nacional Autónoma de México, México D.F., Mexico. Electronic address: jeguarnerosz@cirugiageneralangelesmocel.com.
authors.forename: Joaquín E
authors.initials: JE
authors.lastname: Guarneros-Zárate
authors.affiliation: Residente de Segundo año Cirugía General, Hospital Angeles Mocel, México D.F Facultad Mexicana de Medicina, Universidad La Salle, México D.F., Mexico. Electronic address: jorge.tume@gmail.com.
authors.forename: Jorge
authors.initials: J
authors.lastname: Tueme-Izaguirre
mesh_terms: D013505:Digestive System Surgical Procedures / Q000379:methods; D006801:Humans; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D009626:Terminology as Topic
keywords: Endopelvic fascia; Ligamentum recti laterale; Mesenterium; Mesorectum; Pelvic anatomy; Pelvic ligaments; Terminologia Anatomica; Total Mesorectal Excision