Grading of quality and completeness of the mesorectum in a total mesorectal excision (TME)

	Mesorectum	Defects	Coning	CRM
Complete	Intact, smooth	Not deeper than 5 mm	None	Smooth, regular
Nearly complete	Moderate bulk, irregular	No visible muscularis propria	Moderate	Irregular
Incomplete	Little bulk	Down to muscularis propria	Moderate/marked	Irregular

Both the specimen as a whole (fresh) and cross-sectional slices (fixed) are examined to make an adequate interpretation.

CRM: circumferential resection margin.

From: Parfitt JR, Driman DK. The total mesorectal excision specimen for rectal cancer: a review of its pathological assessment. J Clin Pathol 2007; 60:849. Reproduced with permission from BMJ Publishing Group Ltd. Copyright © 2007.

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Grading of quality and completeness of the mesorectum in a total mesorectal excision (TME)