at the anastomosis site was removed completely up to the tunica muscularis recti.
Surgery consisted in resection of the tumour together with bladder, prostate, rectal stump and mesorectum
(a supralevator pelvic exenteration), a 50 cm small bowel loop and the part of the abdominal wall involved by the tumour.
MRI is mostly accurate in evaluating the mesorectum
and the mesorectal fascia which are considered the most relevant prognostic factors for local recurrence.
Now that we better understand the nature of local spread in the mesorectum
, meticulous dissection, and very low stapling or suturing techniques have allowed far more sphincter-sparing procedures, without any increase in local recurrence.
Miles' observed lymph node metastases along the mesorectum
and the vessels as far as the inferior mesenteric artery and aorta in patients with rectal cancer.
The vessels of the mesorectum
were carefully ligated, the prolapsed rectum was resected, and a hand-sewn interrupted colo-anal anastomosis in two layers was created.
There should be no breakdown of mesorectum
, no tension of the anastomosis and there must be adequate margins i.
Their prevalence ranges from 6% to 64% in the mesorectum
(77) and from 17% to 55% along the length of the colon.
He pointed out that the removal of entire mesorectum
leads to lower recurrence which is less than 10%.
For upper-third rectal tumours, the mesorectum
was separated up to 5 cm below the lesion.
is a fatty tissue layer of about 2 to 3 cm in thickness, with in lying blood vessels, nerves, lymphatics, and lymph nodes.
It has been shown that macroscopic pathologic assessment of the completeness of the mesorectum
of the specimen, scored as complete, partially complete, or incomplete, accurately predicts both local recurrence and distant metastasis.