Bosch Steven L, Nagtegaal Iris D
Department of Pathology 824, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, the Netherlands.
Curr Colorectal Cancer Rep. 2012 Jun;8(2):90-98. doi: 10.1007/s11888-012-0124-7. Epub 2012 Mar 27.
Total mesorectal excision (TME) is considered standard of care for rectal cancer treatment. Failure to remove the mesorectal fat envelope entirely may explain part of observed local and distant recurrences. Several studies suggest quality of the mesorectum after TME surgery as determined by pathological evaluation may influence prognosis. We aimed to determine the prognostic value of the plane of surgery as well as factors influencing the likelihood of a high-quality specimen by reviewing the literature. A pooled meta-analysis of relevant outcome data was performed where appropriate. A muscularis propria resection plane was found to increase the risk of local recurrence (RR 2.72 [95 % CI 1.36 to 5.44]) and overall recurrence (RR 2.00 [95 % CI 1.17 to 3.42]) compared to an (intra)mesorectal plane. Plane of surgery is an important factor in rectal cancer treatment and the documentation by pathologists is essential for the improvement of TME quality and patient outcome.
全直肠系膜切除术（TME）被认为是直肠癌治疗的标准术式。未能完全切除直肠系膜脂肪包囊可能是部分观察到的局部和远处复发的原因。多项研究表明，经病理评估确定的TME手术后直肠系膜的质量可能会影响预后。我们旨在通过回顾文献来确定手术平面的预后价值以及影响高质量标本可能性的因素。在适当的情况下，对相关结局数据进行了汇总荟萃分析。与（在）直肠系膜平面相比，固有肌层切除平面会增加局部复发风险（风险比2.72 [95%置信区间1.36至5.44]）和总体复发风险（风险比2.00 [95%置信区间1.17至3.42]）。手术平面是直肠癌治疗中的一个重要因素，病理学家的记录对于提高TME质量和患者预后至关重要。
