with Dr. Yoshiharu Sakai
Rectal cancer accounts for approximately one third of all colorectal cancers. Since the early 1990s, total mesorectal excision (TME) has remained the gold standard surgical treatment for rectal cancer, following Prof. Heald’s detailed description of the technique in 1986. In this era of the multidisciplinary approach, the quality of TME has been shown to be a significant prognostic factor for cancer-specific survival. The TME technique has evolved from traditional ‘open’ to minimal access approaches, such as laparoscopic, robotic and more recently, transanal techniques. However, acceptance of one option as better than or even equivalent to the others remains a matter of debate.
A 68-year-old patient with a BMI of 28.5 kg/m2 and a previous clinical history of rectal bleeding for 2 years due to a hemorrhoidal pathology that required sclerotherapy. Subsequently, a colonoscopy was performed in which a neoplasm of the rectum was observed 8 cm from the anal verge. Biopsy showed a well differentiated adenocarcinoma. The study was completed with an MRI that showed a mid-rectal cancer T3aN1M0, EMVI(-), CRM(-); a CT scan with no distant metastasis and blood test with CEA 3.1
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