Our results
Larger differences exist between the local recurrence and cure rates of different surgeons
than in any other common malignancy. TME figures from the North Hampshire Hospital, Basingstoke
are the best so far published
see The Basingstoke Experience of Total Mesorectal Excision, 1978-1997
Approximately 20% of new patients in Southern UK have metastases or
incurable disease at the time of presentation. Of the remaining 80%
at least three quarters can be cured by TME surgery
Conventional surgery involves the establishment of a permanent colostomy
in 50-60% of cases. TME surgery in specialized hands can reduce this figure
to as low as 10%. There are certain extra post-operative hazards involved in
reconstituting bowel continuity on very low cases. For this reason a
temporary colostomy or ileostomy is usually advised. This is normally reversed
by a minor operation after 6 to 8 weeks
see Abdominoperineal Excision of the Rectum - an endangered operation
The principle danger of the very lowest anastomoses close to the anal canal
is that they do not heal as reliably as those performed further up the bowel.
This is the reason for the temporary colostomy or ileostomy
see Leakage from stapled low anastomosis after total mesorectal excision
for carcinoma of the rectum
The precision required to perform a successful TME enables the surgeon to identify, and therefore preserve, the nerves of the sexual and bladder functions
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