Author Affiliation: Department of Colorectal
Surgery, Beaumont Hospital, Dublin, Ireland.
Leroy and colleagues1 report
their exceptional achievement in providing for a patient with rectal
neoplasia an oncologically packaged TME entirely via a pure natural
orifice (transanal, transrectal) approach. While the ultimate pathology
proved benign (and so meaning that a more conventional intraluminal
microsurgical/endoscopic resection would also have conferred a cure
in this particular instance), Leroy and colleagues have studiously
developed an operative strategy whose realization is more than just
a potential additional niche in our therapeutic armamentarium for
mid- to low-rectal tumors. Their implicit separation of the mesorectal
excision component from the mesocolic lymphadenectomy inherent to
the standard transabdominal operation (whatever the access) may also
portend an era of stratified resective extent for colorectal cancer
individualized by preoperative staging and molecular profiling.
Cahill R. From TEM to TME: Comment on “No-Scar Transanal Total Mesorectal Excision”. JAMA Surg. 2013;148(3):231. doi:10.1001/jamasurg.2013.703
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