Fig. 12.1 The correct plane in total mesorectal excision TME is associated with improved local control and survival rates. The local recurrence rate following total mesenteric excision with an APR…

Fig. 19.1 CT 3-dimensional system to evaluate pattern of recurrence (With kind permission from Springer Science + Business Media: Höcht et al. [21], p. 110) Magnetic resonance imaging (MRI) is…

Fig. 13.1 Lateral lymph nodes (yellow circles) defined by the Japanese Classification of Colorectal Carcinoma. Internal iliac nodes, common iliac nodes, obturator nodes and external iliac nodes constitute the lateral…

Fig. 6.1 Mid rectal annular tumour spreads beyond the muscularis propria up to 8 mm (a– yellow arrows). Mesorectal fascia (b – red line, which defines the mesorectum) is involved…

Modified lithotomy position Digital rectal examination to assess level of tumor in relation to dentate line and fixation of tumor Laparoscopic approach unless contraindicated Complete mobilization of left colon Identification…

Fig. 29.1 Deep pelvic dissection anatomy Bleeding Hemorrhage can occur suddenly when the presacral fascia is breached and pelvic veins are injured. Manual pressure or suture ligation can curtail most…

Fig. 11.1 (a) Plane of resection utilized when TME plane is followed to its termination. A waist is produced at the level of the puborectalis. (b) Plane of resection when…

High risk Low risk Poor differentiation Well and moderate differentiation Size ≥3 cm Size <3 cm Circumferential involvement ≥30 % of lumen Circumferential involvement <30 % of lumen Presence of…

Fig. 3.1 Embryonal development of the cloaca (Reproduced from Schunke M, et al. Promethius LernAtlas der Anatomie, vol. 2. 3rd ed. Stuttgart: Thieme Publ.; 2012, with permission) At this point…

Fig. 10.1 T2 weighted MRI showing invasion of tumor posteriorly into the sacrum. The arrow shows tumor invasion within the posterior compartment Despite all the recent developments in surgery and…