Total mesorectal excision

Total mesorectal excision (TME) is a standardized surgical procedure for the continence- preserving treatment of cancer of the rectum ( rectum ), the colorectal carcinoma . The method has significantly reduced the recurrence rate after rectal cancer surgery over the past 20 years . Furthermore, the surgical technique reduces disturbances of the bladder and sexual function, as the local autonomic nerve plexuses of the pelvis are preserved. In the current S3 guideline, TME is the recommended procedure for tumors of the middle and lower third of the rectum.

The British surgeon RJ "Bill" Heald , the developer of total mesorectal excision, discovered during the resection of rectal cancer that the fatty tissue (mesorectum) between the rectum and sacrum is often riddled with metastases. On the basis of this knowledge, the entire fatty tissue and lymphatic tissue are removed in TME in order to prevent local recurrences.

Sources and individual references

^ RJ Heald, ND Karanjia: Results of radical surgery for rectal cancer. In: World Journal of Surgery . Volume 16, Number 5, 1992 Sep-Oct, pp. 848-857, PMID 1462619 (Review).
↑ WE Enker: Total mesorectal excision-the new golden standard of surgery for rectal cancer. In: Annals of medicine. Volume 29, Number 2, April 1997, pp. 127-133, PMID 9187227 (Review).
↑ K. Havenga, WE Enker u. a .: Male and female sexual and urinary function after total mesorectal excision with autonomic nerve preservation for carcinoma of the rectum. In: Journal of the American College of Surgeons. Volume 182, Number 6, June 1996, pp. 495-502, PMID 8646349 .
↑ Oncology Guideline Program (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF): S3 Guideline Colorectal Carcinoma , Long Version 1.0, AWMF Registration Number: 021-007O; p.110 (PDF)
↑ RJ Heald, EM Husband, RD Ryall: The mesorectum in rectal cancer surgery - the clue to pelvic recurrence? In: The British Journal of Surgery . Volume 69, Number 10, October 1982, pp. 613-616, PMID 6751457 .

literature

Chir Gastroenterol 2005; 21: 131-136 (special issue on rectal cancer), also available as ISBN 3-8055-7955-1
Junginger et al. Total mesorectal excision can prevent urogenital dysfunction. Dtsch Arztebl 2004; 101: A 3106–3110 {Issue 46}
HP Klotz Total Mesorectal Excision (TME): Breakthrough in the therapy of rectal cancer. Swiss Medical Journal; 2000; 81: No. 44 (PDF; 299 kB)

[PMID1462619-1] RJ Heald, ND Karanjia: Results of radical surgery for rectal cancer. In: World Journal of Surgery . Volume 16, Number 5, 1992 Sep-Oct, pp. 848-857, PMID 1462619 (Review).

[PMID9187227-2] WE Enker: Total mesorectal excision-the new golden standard of surgery for rectal cancer. In: Annals of medicine. Volume 29, Number 2, April 1997, pp. 127-133, PMID 9187227 (Review).

[PMID8646349-3] K. Havenga, WE Enker u. a .: Male and female sexual and urinary function after total mesorectal excision with autonomic nerve preservation for carcinoma of the rectum. In: Journal of the American College of Surgeons. Volume 182, Number 6, June 1996, pp. 495-502, PMID 8646349 .

[4] Oncology Guideline Program (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF): S3 Guideline Colorectal Carcinoma , Long Version 1.0, AWMF Registration Number: 021-007O; p.110 (PDF)

[PMID6751457-5] RJ Heald, EM Husband, RD Ryall: The mesorectum in rectal cancer surgery - the clue to pelvic recurrence? In: The British Journal of Surgery . Volume 69, Number 10, October 1982, pp. 613-616, PMID 6751457 .