TME quality in rectal cancer surgery

• Published in: European journal of medical research Vol. 15; no. 7; pp. 292 - 296
• Main Authors: Herzog, T, Belyaev, O, Chromik, A M, Weyhe, D, Mueller, C A, Munding, J, Tannapfel, A, Uhl, W, Seelig, Matthias H
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 26-07-2010; BioMed Central; BMC
• Subjects: Adult; Aged; Aged, 80 and over; Care and treatment; Colorectal cancer; Colorectal surgery; Digestive System Surgical Procedures - standards; Female; Health aspects; Humans; Male; Medical care; Middle Aged; Quality Control; Quality management; rectal cancer; Rectal Neoplasms - pathology; Rectal Neoplasms - surgery; surgery; total mesorectal excision; Germany
• ISSN: 2047-783X; 0949-2321; 2047-783X
• DOI: 10.1186/2047-783x-15-7-292

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.
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).
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).
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.