Document Detail

Do supervised colorectal trainees differ from consultants in terms of quality of TME surgery?
MedLine Citation:
PMID:  17032327     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The quality of surgical excision is held to be a major determinant of outcome following surgery for rectal cancer. Macroscopic examination of the excised mesorectum allows for reproducible assessment of the quality of surgery. We aimed to determine whether quality of excision undertaken by colorectal trainees under supervision was comparable with that performed by consultants, as measured using mesorectal grades. METHOD: A total of 130 consecutive patients undergoing potentially curative resection for primary adenocarcinoma of the rectum in our centre from 2001 to 2003 were included in the study. The pathologists graded the excised mesorectum according to staged classification proposed by Quirke. The outcome (quality of mesorectal excision and secondary outcomes including local recurrence and overall recurrence) of operations performed by consultants was compared with that of trainees. Statistical significance was tested using Pearson chi(2) test. RESULTS: Eighty-nine operations were performed by consultants and 41 by senior colorectal trainees with consultant supervision. Forty-four patients (49%) had good mesorectum when operated by consultants in comparison with 17 (41.5%) by the trainees. There was no statistically significant difference (P = 0.717) between the two groups in terms of quality of mesorectum excised after potentially curative resection. Furthermore, there were seven local recurrences in patients operated by consultants (7.8%) when compared with four in the trainee group (9.5%) and once again there was no statistical significance between the two groups (P = 0.719). CONCLUSION: We conclude that the quality of rectal cancer excision, as defined by mesorectal grades, achieved by supervised colorectal trainees is comparable with that achieved by consultants.
S Maslekar; A Sharma; A Macdonald; J Gunn; J R T Monson; J E Hartley
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland     Volume:  8     ISSN:  1462-8910     ISO Abbreviation:  Colorectal Dis     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-10-11     Completed Date:  2007-01-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883611     Medline TA:  Colorectal Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  790-4     Citation Subset:  IM    
Academic Surgical Unit, University of Hull, Castle Hill Hospital, Cottingham, East Yorkshire, UK.
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MeSH Terms
Clinical Competence*
Digestive System Surgical Procedures / methods,  standards*
Great Britain
Internship and Residency*
Neoplasm Recurrence, Local
Quality of Health Care*
Rectal Neoplasms / surgery*
Rectum / anatomy & histology
Retrospective Studies
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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