An alternative technique to achieve mesorectal excision in upper rectal cancer in a narrow pelvic cavity

Abstract

PURPOSE: Appropriate partial mesorectal excision (PME) is extremely important for prevention of local recurrence in rectal cancer. However, it is not always easy to conduct PME in the narrow pelvic cavity. We used a new surgical technique that involves a rectal transection followed by PME. MATERIAL AND METHODS: After rectal mobilization in the layer targeted for total mesorectal excision, only the rectal wall was bluntly dissected at an appropriate distance from the tumor. Initial transection of the rectum draws the rectum toward the anal side so that the mesorectum can be excised in a good visual field. Excision of the mesorectum was easy, and it could be resected in a short time. RESULTS: This technique was conducted on twenty patients with upper rectal cancer and on eight patients with rectosigmoid cancer. Separation of the rectal wall was comparatively easy. The average distance from the rectal stump to the distal mesorectum in the freshly resected specimen was 15 mm, indicating satisfactory PME. CONCLUSION: This easily performed method is a promising procedure for achieving sufficient PME in upper rectal cancer. Scripta Scientifica Medica 2013; 45(4): 56-58.