Total mesorectal excision and sphincter preservation — the early steps of rectal cancer surgery

AbstractThe treatment of rectal cancer has evolved significantly over the last 100 years. Standardiza- tion of total mesorectal excision and the development of techniques for sphincter preserva- tion have resulted in significant improvements in the management of this disease. Still, local disease control and functional outcomes of sphincter preserving procedures remain a rel- evant issue. In this historical paper, the oncological and functional outcomes of patients with rectal cancer treated between 1960 and 1971 by a pioneer woman surgeon using a sphincter preserving approach and a technique resembling total mesorectal excision performed at that time are reported. The results reflect one of the earliest steps of partial intersphincteric resec- tion and total mesorectal excision with good oncological outcomes (2% local recurrence) and acceptable functional outcomes in a highly selected group of patients