Role of total mesorectal excision and of circumferential resection margin in local recurrence and survival of patients with rectal carcinoma.

Rectal cancer is a common disease with poor prognosis because of local recurrence and metastases. Local recurrence arises mainly as a result of incomplete surgical resection. Evaluation of completeness of the mesorectum provides significant information about prognosis. Total mesorectal excision (TME) has become the surgical treatment of choice for rectal cancer because adopting the principles of TME achieves very low local recurrence rates. The adoption of the TME principles along with the estimation of the circumferential resection margin on the non-peritonealized surface of the resected rectal specimen are the most important predictors of local recurrence.