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- W1991134583 abstract "Total mesorectal excision (TME) is now widely accepted as the gold standard operation for rectal cancer surgery and its implementation is stimulating the development of an exciting new chapter in surgical education [1–4]. It is also key to the important rise of MRI as an imaging modality in pelvic tumour management. TME is a system of rectal cancer management that defines the block of tissue to be excised and describes the surgical detail of how this is to be achieved [5, 6]. It is now more readily comprehended by non-surgeons because of the development by specialist MRI radiologists of images that are far superior to anything previously achievable [7]. The fine slice high resolution methods are demonstrably superior to any X-ray based modality, which inevitably suffers limitations in differentiating tumour tissue from muscle wall. MRI demonstrates, for the first time, the contours of the mesorectum and the distribution of the cancer within it. Such imaging will in the future provide a rational basis for selecting those cases for radiotherapy or chemotherapy where the mesorectal margin is in danger of being breached during surgery. It can also provide a ‘‘workshop guide’’ for the detailed surgery, whether this be performed laparoscopically or open. This may become a crucial ‘‘route map’’ as laparoscopic surgeons increasingly extend their dissection into the challenging depths of the true pelvis where the inability to feel the cancer can be a serious disadvantage. The value of a ‘‘concept operation’’ like TME depends ultimately on how effectively it can be taught. The principal practical weapon in teaching the actual surgery has become the video camera and the measurement of progress is the meta-analysis of results from whole populations. Many years ago the distinguished American Professor Bill Silen made the following prescient observation in the Lancet [8]:" @default.
- W1991134583 created "2016-06-24" @default.
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- W1991134583 date "2005-10-01" @default.
- W1991134583 modified "2023-10-16" @default.
- W1991134583 title "Surgical management of rectal cancer: a multidisciplinary approach to technical and technological advances" @default.
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- W1991134583 doi "https://doi.org/10.1259/bjr/25335482" @default.
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