What are the steps to perform total mesorectal excision (TME)?

Updated: Feb 16, 2021
  • Author: Nanda Kishore Maroju, MRCS, MS, MBBS, DNB; Chief Editor: Kurt E Roberts, MD  more...
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The main steps of performing an anterior resection include the following:

  • Laparotomy and exploration for confirming the stage of the disease and assessing operability on the table
  • Mobilization of the left colon and the splenic flexure
  • Mobilization of the rectum
  • Resection of the rectal tumor along with sigmoid colon
  • Reconstruction

Although each step of the procedure has its own significance towards a successful outcome of the procedure, mobilization of the rectum is of primary importance in terms of cancer control; it also has a bearing on nerve preservation and reduced intraoperative bleeding. Total mesorectal excision (TME) essentially describes the recommended technique of mobilizing the rectum; of the various techniques, it has the lowest incidence of positive margins and local recurrence.

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