Total Mesenteric Excision in the Surgical Treatment of Rectal Cancer

Abstract
DURING THE past 2 decades, the ratio of sphincter ablating procedures (SAP) to sphincter preserving procedures (SSP) has been reversed in the treatment of rectal adenocarcinoma. The widespread availability and use of modern stapling devices, the recognition that a shorter distal margin is adequate, and newer "ultra-low" anastomotic and endoluminal techniques have all contributed to this progress. Yet, certain perioperative anatomic factors still limit the choice of surgical treatment to SAP.