eP381 - Breakthrough in Rectal Cancer Surgery: Total Mesorectal Excision Technique

Purpose/Background: Since its discovery by Richard Heald 40 years ago, total mesorectal excision (TME) has been the gold standard of care for curative resection of rectal cancer. Progress in rectal cancer surgery survival is a historic moment in medicine, with the most significant contribution made by the standardization and widespread implementation of total mesorectal excision. As the third most commonly diagnosed cancer in males, rectal cancer has been historically known as an unsurvivable disease due to a poor understanding of the disease and its behavior and the lack of proper standardization techniques. The multimodal surgical management of rectal cancer and its poor prognosis have led pioneer surgeons to develop and introduce the gold standard treatments for rectal surgery, like the total mesorectal resection, into clinical practice.Methods/Interventions: Over the past 100 years, techniques and technologies have continuously evolved to improve the patient’s survival outcomes and quality of life. Before the mid-1980s, abdominoperineal resection was the gold standard for rectal cancer surgery for many years. The procedure was first described by Sir William Miles in 1908. Still, it resulted in high pelvic failure, higher morbidity, and death rates due to a high number of local recurrences after resection for rectal cancer.Results/Outcomes: The most significant benefit of the concept of the TME is the decrease of local recurrence rectal to 6 to 12%, and 5-year survival improved by 53-87%.Conclusion/

Discussion: The TME is a nerve-sparing dissection that may likely prevent bladder and sexual dysfunction as other standard procedures. In the early 1980s, Professor Heald developed the present gold standard treatment of rectal cancer known as total mesorectal excision or TME, a breakthrough in the world of colorectal surgery. Significant improvements in recurrence, survival, and improvement of oncologic surgery of the rectum have resulted since the development of this newer technique for curative resection of rectal cancer. The principle of the TME is a precise dissection of the rectum and the pararectal lymph nodes within the mesorectal envelope. This technique has served to improve the outcome of the rectal cancer patients.