Colorectal tumour deposits in the mesorectum
and pericolon; a critical review.
The task is to free the rectum with an intact mesorectum
all around up to the level of the levators.
in rectal cancer surgery--the clue to pelvic recurrence?
Ryall, "The mesorectum
in rectal cancer surgery--the clue to pelvic recurrence?," The British Journal of Surgery, vol.
at the anastomosis site was removed up to the tunica muscularis recti.
[sup] Because mesorectum
is a potential metastatic site for rectal cancer, total mesorectal excision (TME) has become the standard surgical intervention in LARC patients, which involves sharp dissection of rectosacral fascia, excision of rectum, and mesorectum
at the level of the levators.
Abdominal CT scan showed a large tumour (size 148/100/96 cm) involving the rectal stump, the bladder wall, prostate, mesorectum
and ileal small bowel loops (Fig.
They are different from colon or intraperitoneal rectal injuries because below the peritoneal reflection the rectum is encased by the mesorectum
and surrounded by the soft tissues of the pelvis.
A TME involves removing the entire mesorectum
, without disturbing nerve or sphincter function, to eliminate the cancer.
There may be little benefit to radiotherapy for patients with T3N0 rectal cancer resected using total mesorectal excision with negative radial margins if there is minimal invasion of the mesorectum
MRI noted minimal infiltration in the perirectal fat plane and lymphadenopathy within the mesorectum
, with the largest lymph node having a short axis measuring 5 mm.
Restaging MRI revealed reduction in tumour size with areas within the mesorectum
consistent with perforation/infection that lies close to anterior circumferential resection margin.