Total mesorectal excision ( TME ) is a standard technique for the treatment of colorectal cancer, first described in 1982 by Professor Bill Heald at Basingstoke UK Hospital. Significant intestinal lengths around the tumor are removed, such as the surrounding tissue to the plane between the mesorektum and the presacral fascia (Heald's "holy plane"). Dissection along this plane facilitates direct dissection and retention of the sacral vessels and hypogastric nerves. It is possible to recombine with both ends of the large intestine; However, most patients require a temporary ileostomy bag to pass through the colon, allowing it to heal with the risk of perforation or smaller leakage.
TME has become a "gold standard" treatment for rectal cancer in the West.
The occasional side effect of surgery is the formation and tangling of fibrous bands from near the operating site with other parts of the intestine. It can cause intestinal infarction if not surgery.
TME results in lower recurrence rates than traditional approaches and lower permanent colostomy levels. Postoperative healing is somewhat increased compared to competitive methods. When practiced with diligent attention to anatomy there is no evidence of increased risk of urinary incontinence or sexual dysfunction. However, partial fecal incontinence may occur and/or "clustering" - a series of emergency trips to the toilet separated by a few minutes, each trip yielding only very small results.
Usually combined with neoadjuvant radiotherapy.
Video Total mesorectal excision
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Source of the article : Wikipedia
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