Locoregional recurrence is one of the most important problems after surgery for rectal cancer. Four to five per cent local recurrence rates have been reported after total mesorectal excision with autonomic nerve preservation. After an anatomic description, the authors describe the surgical technique of total mesorectal excision with nerve preservation. Carcinologic and functional results are reported, before concluding that this technique should be performed for mid or low rectal tumours with a distance to anorectal junction less than 5 cm.

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