Total Mesorectal Excision Technique-Past, Present, and Future

摘要: While the treatment of rectal cancer is multimodal, above all, a proper oncological resection critical. The surgical management has substantially evolved over past 100 years, and continues to progress as we seek best treatment. Rectal was historically an unsurvivable disease, with poor understanding embryological planes, lymphatic drainage, lack standardized technique. Major improvements in recurrence, survival, quality life have resulted from advances preoperative staging, pathologic assessment, development timing multimodal therapies, most significant contribution advancing care may be standardization widespread implementation total mesorectal excision (TME). TME, popularized by Professor Heald early 1980s sharp, meticulous dissection tumor mesorectum all associated lymph nodes through avascular embryologic plane, shown universal reproducible reductions local recurrence improvement disease-free overall survival. Widespread education training surgeons worldwide TME significantly impact outcomes for surgery, procedure become gold standard curative cancer. In this article, discuss evolution abdominal approach emphasis on history, relevant anatomy, steps, oncologic outcomes, technical evolution.