Total mesorectal excision

Chemotherapy and radiation therapy play an important role in the management of colorectal carcinoma. Significant improvements in tumor control and overall survival have been demonstrated with the use of combined-modality therapy in several randomized clinical trials performed over the past 25 yr. This chapter reviews the role of adjuvant chemotherapy and radiation therapy for colon and rectal cancer. Issues surrounding chemoradiation for rectal cancer, including sphincter preservation, total mesorectal excision, local excision, and newer chemotherapy agents, are also discussed. 

Enker WE, Thaler HT, Cranor ML, Polyak T. Total mesorectal excision in the operative treatment of carcinoma of the rectum. J Am Coll Surg 1995 181(4) 335—346. 

Heald RJ, Moran BJ, Ryall RD, et al. Rectal cancer the Basingstoke experience of total mesorectal excision, 1978-1997. Arch Surg 1998 133(8) 894—899. 

Kapiteijn E, Marijnen CAM, Nagtegaal ID, et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. N Engl J Med 2001 345(9) 638-646. 

For treatment of rectal cancer, minimally invasive surgery, such as transanal excision, transanal endoscopic microsurgery, total mesorectal excision, or abdominoperineal resection, are available depending on the location, size, and stage of the tumor (Pricolo... 

Heald RJ (1995) Total mesorectal excision is optimal surgery for rectal cancer. Br J Surg 82 1297-1299... 

Staging of rectal cancer is relatively different from colon cancer. In fact, total mesorectal excision, with resection of the tumor together with surrounding mesorectal fat, is nowadays the surgically accepted treatment of choice for rectal cancer, as it is associated with a recurrence... 

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