Surgical results of total mesorectal excision for rectal cancer in a specialised colorectal unit.

Our aim was to review the results of total mesorectal excision (TME) in a specialised colorectal unit. Perioperative and follow-up data were prospectively collected in a computerised database. A review of all the records was made. The morbidity rate was about 14%, and was higher in patients with coloplasty due to a higher anastomotic leak rate. The local recurrence rate was 2%, the distant metastasis rate was 11%, and both local and distant metastasis occurred in 4%. About 95% of recurrence occurred within 3 years. There was better bowel function in patients with a colonic J-pouch in the first 2 years after surgery, but the advantage disappeared thereafter. There were no differences in function between descending and sigmoid colonic J-pouches. TME in a specialised colorectal unit has low morbidity and mortality. Our procedure of choice is that of a sigmoid colon J-pouch anal anastomosis.