ReviewTotal Mesorectal Excision, an erroneous anatomical term for the gold standard in rectal cancer treatment

- The term mesenterium makes references to a structure composed of a double layer of peritoneum.
- The term mesorectum is wrong and is not included in the Terminologia Anatomica.
- The IFAA'S Terminologia Anatomica is the result of an International Consensus to unify the anatomic nomenclature.
- We urge the oncological community to appreciate the harm involved with the use of the term mesorectum.

In 1986 Professor R J Heald published in The Lancet his new technique which he called Total Mesorectal Excision; today this is the gold standard for the surgical management of rectal cancer. In Total Mesorectal Excision (TME), the mesorectum is the term used to describe all the peri-rectal connective tissue including the posterior sheath of the endopelvic fascia containing the peri-rectal neurovascular structures. However, the mesenterium is a defined structure composed of a double layer of peritoneum which does not include the endopelvic fascia and the lateral rectal stalks, so these should not be included in the term 'mesorectum'.In our globalized medical culture it is important to use anatomic terms approved by the International Federation of Associations of Anatomists, as contained in the Terminologia Anatomica produced by the Federative International Programme for Anatomical Terminology (FIPAT). The term mesorectum is not listed in the Terminologia Anatomica.