ABSTRACT
Colorectal cancer is the most common gastrointestinal cancer. One of the main problems in the treatment of rectal cancer is the development of local recurrence. Recurrences of rectal cancer are often confined to the pelvis without distant metastases and considered as a loco-regional failure. Total mesorectal excision [TME] was described 25 years ago and is now being established as the therapeutic gold standard for rectal cancer surgery in a number of countries worldwide. The analysis of this study which included 54 patients who underwent potentially curative radical surgery for rectal cancer showed that the introduction of TME has led to substantial lower loco-regional recurrence rate within the first 2 years postoperatively from 66.6% in group A [20 patients] to 33.3% in group B [34 patients]. Further improvement was recognized in group B2 who underwent TME + short course of preoperative radiotherapy. However the risk of anastomotic leak was higher among the low anterior resection+ TME group [5 patients] 25%, specifically in those who received a short term preoperative radiotherapy, in comparison with patients among [group A] who underwent curative low anterior resection without TME. Despite the initial controversy. TME + preoperative short term adjuvant radiotherapy is now a feasible, reproducible, adjunctive therapy in the management of rectal cancer