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LOW ANTERIOR RESECTION OF THE RECTUM WITH TOTAL MESORECTAL EXCISION. SURGICAL - TECHNIQUE

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Author(s): I. Radu | Maria Gabriela Aniţei | V. Scripcariu | Cr. Dragomir

Journal: Jurnalul de Chirurgie
ISSN 1584-9341

Volume: 7;
Issue: 4;
Start page: 692;
Date: 2011;
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Keywords: TOTAL MESORECTAL EXCISION | RECTAL CANCER | SURGICAL TECHNIQUE

ABSTRACT
Local recurrence after surgery for rectal cancer remains a major issue for all surgeons who treat these disorders. RJ Heald has shown that there are lymph nodes metastasis in mesorectum, distal to rectal tumor. This is the reason why, for inferior and middle rectal tumour, total mesorectal excision should be performed as a routine. The key to this intervention consists in a sharp and meticulous dissection around the fatty mesorectum, without breaking the mesorectal fascia. Special attention should be paid on colorectal anastomosis, this could be performed stapled or handsewn. Defunctioning ileostomy must be accepted by the patient and the surgeon, considering the potential septic risk in the event of a fistula.
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