In total mesorectal excision (TME) for rectal cancer, the circumferential resection margin (CRM) is considered positive (predicting local recurrence) when the tumour is within what distance of the mesorectal fascia?

• A Within 1 mm ✓
• B Within 5 mm
• C Within 2 mm
• D Within 3 mm

Explanation

A positive CRM is defined as tumour within 1 mm of the mesorectal resection margin on histopathology. A positive CRM is the single most important predictor of local recurrence after rectal cancer surgery and is associated with systemic recurrence and reduced overall survival. TME, first described by Heald, involves sharp dissection in the embryological avascular plane between mesorectal fascia and parietal pelvic fascia to achieve an intact mesorectal envelope with negative margins.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.