Mesorectal Excision Surgery

For patients with advanced rectal cancers, surgery that includes total mesorectal excision (TME) often provides the best possible patient outcomes and survival.

How total mesorectal excision surgery works

The mesorectum is a fatty tissue directly adjacent to the rectum that contains blood vessels and lymph nodes. When rectal cancers recur, it is often in these lymph nodes. In a TME surgery, Stanford Cancer Center surgeons carefully remove the entire mesorectum and lymph nodes, leading to a very low risk that cancer will recur in the local region (generally = 9 percent).

TME surgery sometimes impairs rectum function and results in patients needing a permanent colostomy. Although the risk is never eliminated, having your surgery performed by an experienced physician such as those at the Cancer Center can make this outcome less likely.

Following surgery, patients sometimes also receive radiation and/or chemotherapy.

Patients who can receive total mesorectal excision surgery

Patients who have rectal cancer that is confined to the lower two-third of the rectum are generally considered good candidates for TME surgery. However, many factors can determine whether TME is right for you, and your Cancer Center physician will ultimately help you choose the most appropriate treatment for your individual situation.

Stanford expertise

Although TME surgery improves outcomes, it is also a complicated, major surgery. In addition to lowering the risk of permanent colostomy, having an experienced surgeon can also reduce the risk of damage to important nerves that run through the mesorectum. For example, when surgeons can spare the pelvic nerves, patients have less urinary and sexual problems after surgery.

Despite the greatest care, management of post-surgery complications can be challenging for patients. In addition to our experienced surgeons, the Cancer Center also has exceptional nurses, specialists, and support groups to help you minimize and adapt to side effects.