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Factors influencing the quality of total mesorectal excision.
MedLine Citation:
PMID:  22311576     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Total mesorectal excision (TME) has become the standard of care for rectal cancer. Incomplete TME may lead to local recurrence. METHODS: Data from the multicentre observational German Quality Assurance in Rectal Cancer Trial were used. Patients undergoing low anterior resection for rectal cancer between 1 January 2005 and 31 December 2009 were included. Multivariable analysis using a stepwise logistic regression model was performed to identify predictors of suboptimal TME. RESULTS: From a total of 6179 patients, complete data sets for 4606 patients were available for analysis. Pathological tumour category higher than T2 (pT3 versus pT1/2: odds ratio (OR) 1·22, 95 per cent confidence interval 1·01 to 1·47), tumour distance from the anal verge less than 8 cm (OR 1·27, 1·05 to 1·53), advanced age (65-80 years: OR 1·25, 1·03 to 1·52; over 80 years: OR 1·60, 1·15 to 2·22), presence of intraoperative complications (OR 1·63, 1·15 to 2·30), monopolar dissection technique (OR 1·43, 1·14 to 1·79) and low case volume (fewer than 20 procedures per year) of the operating surgeon (OR 1·20, 1·06 to 1·36) were independently associated with moderate or poor TME quality. CONCLUSION: TME quality was influenced by patient- and treatment-related factors. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Authors:
B Garlipp; H Ptok; U Schmidt; P Stübs; H Scheidbach; F Meyer; I Gastinger; H Lippert
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-6
Journal Detail:
Title:  The British journal of surgery     Volume:  -     ISSN:  1365-2168     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Affiliation:
Institute for Quality Assurance in Surgical Care, Otto-von-Guericke University Medical School, Germany; Department of General, Abdominal and Vascular Surgery, Otto-von-Guericke University Medical School, Germany. benjamin.garlipp@med.ovgu.de.
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