Although many studies have demonstrated the importance of the concept of TME [5, 9-11], real life is very different. Even in highly specialised rectal cancer surgery studies, where we expect motivated and devoted rectal cancer surgeons, TME was incompletely removed in up to 23.9% . Therefore we have to ask ourselves why this is the case.
In principle there are 3 factors responsible for success or failure:
1. patient-related factors
2. tumour-related factors
3. technical factors.
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