Total mesorectal excision
Encyclopedia
Total mesorectal excision (or TME) is a standard technique for treatment of colorectal cancer
, devised some 20 years ago by Professor Bill Heald at the UK's Basingstoke
District Hospital. A significant length of the bowel around the tumour is removed, and the removed lymph system scrutinised for cancerous activity (see lymphadenectomy
). Rejoin of the two ends of the colon may be possible, but it is usual to need at least a temporary ileostomy
pouch.
TME has become the "gold standard" treatment for rectal cancer in the west.
An occasional side effect of the operation is the formation and tangling of fibrous bands from near the site of the operation with other parts of the bowel. These can lead to bowel infarction
if not operated on.
TME results in a lower recurrence rate than traditional approaches and a lower rate of permanent colostomy
. Postoperative recuperation is somewhat increased over competing methods. When practiced with diligent attention to anatomy there is no evidence of increased risk of urinary incontinence or sexual dysfunction.
It is usually combined with neoadjuvant radiotherapy.
Colorectal cancer
Colorectal cancer, commonly known as bowel cancer, is a cancer caused by uncontrolled cell growth , in the colon, rectum, or vermiform appendix. Colorectal cancer is clinically distinct from anal cancer, which affects the anus....
, devised some 20 years ago by Professor Bill Heald at the UK's Basingstoke
Basingstoke
Basingstoke is a town in northeast Hampshire, in south central England. It lies across a valley at the source of the River Loddon. It is southwest of London, northeast of Southampton, southwest of Reading and northeast of the county town, Winchester. In 2008 it had an estimated population of...
District Hospital. A significant length of the bowel around the tumour is removed, and the removed lymph system scrutinised for cancerous activity (see lymphadenectomy
Lymphadenectomy
Lymphadenectomy consists of the surgical removal of one or more groups of lymph nodes. It is almost always performed as part of the surgical management of cancer....
). Rejoin of the two ends of the colon may be possible, but it is usual to need at least a temporary ileostomy
Ileostomy
An ileostomy is a surgical opening constructed by bringing the end or loop of small intestine out onto the surface of the skin. Intestinal waste passes out of the ileostomy and is collected in an external pouching system stuck to the skin...
pouch.
TME has become the "gold standard" treatment for rectal cancer in the west.
An occasional side effect of the operation is the formation and tangling of fibrous bands from near the site of the operation with other parts of the bowel. These can lead to bowel infarction
Bowel infarction
Bowel infarction or "bowel death" results from a severely restricted blood supply to part of the bowel; this can in turn be due to an uncorrected bowel twist or bowel strangulation, or to occlusion of one of the mesenteric arteries....
if not operated on.
TME results in a lower recurrence rate than traditional approaches and a lower rate of permanent colostomy
Colostomy
A colostomy is a surgical procedure in which a stoma is formed by drawing the healthy end of the large intestine or colon through an incision in the anterior abdominal wall and suturing it into place. This opening, in conjunction with the attached stoma appliance, provides an alternative channel...
. Postoperative recuperation is somewhat increased over competing methods. When practiced with diligent attention to anatomy there is no evidence of increased risk of urinary incontinence or sexual dysfunction.
It is usually combined with neoadjuvant radiotherapy.