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Graeme J Poston, R Daniel Beauchamp,Theo J M Ruers TEXTBOOK OF SURGICAL ONCOLOGY, 2007 Informa UK Ltd
Buchmann P. Swiss Surg. 2003;9(3):140-4.Standard technique of oncologic colorectal surgery.)



( Georgiou P, at al. Lancet Oncol. 2009 Nov;10(11):105362. Epub 2009 Sep 18. Extended lymphadenectomy versus
conventional surgery for rectal cancer: a meta-analysis.)
no-touch technique (Buchmann P.
Swiss Surg. 2003;9(3):140-4.Standard technique of oncologic
colorectal surgery.)

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Sir Ernest Miles

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Lancet 1908


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10 30 %

- TME (Heald RJ) 1982

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Dutch TME Trial

APR
CRM +

30 %

38 %

CRM -

9%

72 %
Nagtegaal et al. J Clin Oncol 23; 9257 9264, 2005

 total mesorectal excision

1. Abel AL (1931) The modern treatment of cancer of the
colon and rectum. Milwaukee Proc 296300
2. Heald RJ, Husband EM, Ryall RO (1982)
Themesorectumin rectal surgery: the clue to pelvic
recurrence? Br J Surg 69:613616

<10%
(2,7%!!!)

 total mesorectal excision

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C
APR
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/ (mm2)

CRM

1411

2550

0.0001

40.6%

14.8%

0.013

22.8%

3.7%

0.025

Holm T. 2010



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45-57%,

49-70%,

52-76%,

28-62%

35-57%,

25-59%,

28%

38%

2-5%

S. O. Breukink 2010; C.J.H. van de Velde 2010






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Transanal Endoscopic Microsurgery Dana R. Sands, 2008


1991

,
(Heald).

Fowler DL, White SA. Laparoscopy-assisted sigmoid resection. Surg Laparosc Endosc.
1991;1:1838.
Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparoscopic
colectomy). Surg Laparosc Endosc.1991;1:14450.

Jensen T. C. Poon, Laparoscopic Resection for Rectal Cancer: A Review

Ann Surg Oncol (2009) 16:30383047





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