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.
The
mesorectum 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.
Mesorectum at the anastomosis site was removed up to the tunica muscularis recti.
[sup][2] 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 [28].
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.