Relationship Between Surgeon Caseload and Sphincter Preservation in Patients With Rectal Cancer

Purves, Harriett; Pietrobon, Ricardo; Hervey, Sheleika; Güller, Ulrich; Miller, William C.; Ludwig, Kirk

doi:10.1007/s10350-004-0793-7

Cited by 61 publications

(44 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…4,5 Moreover, previous studies using national registry data and hospital discharge data have shown that SPS rates vary based on patient demographics, education, geography and surgeon volume. 4,[8][9][10][11][12] However, these data lack critical clinical details, such as tumor location or sphincter involvement, which are necessary to determine if patients are candidates for SPS. This makes it difficult to discern whether the variation in SPS utilization is due to unmeasured case-mix differences or variable selection criteria across centers.…”

Section: Introductionmentioning

confidence: 99%

Multi-institutional assessment of sphincter preservation for rectal cancer.

Abdelsattar¹,

Wong²,

Birkmeyer³

et al. 2014

JCO

View full text Add to dashboard Cite

BACKGROUND-Sphincter preserving surgery (SPS) has been proposed as a quality measure for rectal cancer (RC) surgery. However, previous studies on SPS-rates lack critical clinical characteristics, rendering it unclear if variation in SPS-rates is due to unmeasured case-mix differences or surgeons' selection criteria. In this context, we investigate the variation in SPS-rates at various practice settings.

show abstract

Section: Introductionmentioning

confidence: 99%

Multi-institutional assessment of sphincter preservation for rectal cancer.

Abdelsattar¹,

Wong²,

Birkmeyer³

et al. 2014

JCO

View full text Add to dashboard Cite

show abstract

“…[32][33][34][35]37 We recently demonstrated that patients with rectal cancer treated by high-volume surgeons are 5 times more likely to undergo sphincter-sparing procedures than those treated by low-volume surgeons. 56 It is intuitive that sphincter-sparing procedures, which often represent a technical challenge, are more frequently performed by high-volume surgeons with extensive experience. Based on the findings of this previous investigation, we hypothesized that high-volume surgeons and hospitals are more likely to perform laparoscopic sigmoid resections compared with low-volume surgeons and hospitals, as the laparoscopic resection is often more demanding than the open approach for inexperienced surgeons.…”

Section: Commentmentioning

confidence: 99%

Impact of Surgeon and Hospital Caseload on the Likelihood of Performing Laparoscopic vs Open Sigmoid Resection for Diverticular Disease

et al. 2007

View full text Add to dashboard Cite

show abstract

“…Current data support the belief that surgeon volume, and presumably skill, is one of the two most important factors in sphincter preservation. 8,9 While technical ability has always varied among surgeons, technology has usually been able to help equalize this variation. For rectal cancers, the surgical stapler was the device which helped surgeons work more efficiently in this technically demanding location, facilitating safe anastomoses and even lower resections.…”

Section: Technical Improvementsmentioning

confidence: 99%

Current Concepts in Rectal Cancer

Fleshman

Smallwood

2015

Clinics in Colon and Rectal Surgery

View full text Add to dashboard Cite

Since the first recorded surgical resection for rectal cancer in 1826 by Jacques Lisfranc, 1 the management of rectal cancer has evolved remarkably with dramatic improvements in local recurrence and mortality. Surgical resection is the only proven curative treatment of rectal cancer and the important advances in care have involved improvements in surgical techniques. Most of these improvements during this time period resulted from a better understanding of the anatomy and pathology of rectal cancer. It is important to be familiar with these important advances in rectal cancer treatment to fully understand the current methods of treatment.Historical Overview: From Miles' Abdominoperineal Resection to Today's Sphincter-Preserving Techniques Rectal Resections before MilesGiovanni Morgagni in the early 18th century was the first to propose rectal resection as a treatment for cancer. 1 However, it took over a century before the first successful rectal resection was performed. Over the years, there have been constant changes in the approach used by surgeons to perform a rectal resection.Rectal resections were first performed using a perineal approach as described in 1826 by Jacques LisFranc. 1,2 He operated in the era before anesthesia and proper antiseptic techniques. Since inadvertent entry into the peritoneal cavity could prove lethal, he chose the perineal approach to evert the rectum and perform a limited resection below the peritoneal reflection. A limited amount of rectum was resected with this approach and no attempt was made to purposely include the mesorectum and draining lymph nodes. 2 Success at that time was based upon whether the patient survived to leave the hospital, and so the risk of local recurrence had very little influence. With the advent of anesthesia and aseptic techniques, operations could now be performed that would provide for a more radical resection. Paul Kraske developed a technique similar to Kocher's technique, where he would incise and detach the left side of the coccyx and sacrum to provide more exposure. This exposure allowed him to resect the rectal cancer with ½ inch margins on either side of the rectum. The proximal bowel would then be pulled down and sutured to the anal sphincter complex. However, this "sacral anus" was difficult for the patient to manage. 1,3 Carl Guessenbauer performed the first transabdominal rectal resection and with closure and colostomy in 1879. This procedure would be later popularized by Henri Hartmann for the purpose of treating diverticulitis. 4 Vincent Czerny is credited with performing the first combined abdominal and perineal approach. This combined approach was never intended but was performed only after an unsuccessful attempt at resection through the perineal approach. 1 In Vogel's review of 1,500 cases performed by 12 of the most prominent 19th century surgeons including Billroth, Kocher, Kraske, and Czerny there was a 21% operative mortality rate with a high (80%) recurrence rate. 3 Surgery certainly had progressed beyond LisFranc's perineal res...

show abstract

Relationship Between Surgeon Caseload and Sphincter Preservation in Patients With Rectal Cancer

Cited by 61 publications

References 30 publications

Multi-institutional assessment of sphincter preservation for rectal cancer.

Multi-institutional assessment of sphincter preservation for rectal cancer.

Impact of Surgeon and Hospital Caseload on the Likelihood of Performing Laparoscopic vs Open Sigmoid Resection for Diverticular Disease

Current Concepts in Rectal Cancer

Contact Info

Product

Resources

About