Surgical specialist registrars can safely perform resections for carcinoma of the rectum

Tytherleigh, M. G.; Wheeler, James M.; Birks, Meg; Farouk, Ridzuan

doi:10.1308/003588402760978175

Cited by 15 publications

(17 citation statements)

References 8 publications

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“…In this study, only one positive resection margin was identified in the I-R group. In all the [26,27] and for laparoscopic surgical procedures including laparoscopic colectomy [28][29][30]. The short-term surgical and functional outcomes in the I-R and E-R groups were almost as good as those in the I-E and E-E groups, respectively, and were quite satisfactory, although the expert surgeons obtained significantly better results with respect to operative time in LLARs for extraperitoneal rectal cancer.…”

Section: Discussionmentioning

confidence: 99%

Introduction of laparoscopic low anterior resection for rectal cancer early during residency: a single institutional study on short-term outcomes

et al. 2010

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Section: Discussionmentioning

confidence: 99%

Introduction of laparoscopic low anterior resection for rectal cancer early during residency: a single institutional study on short-term outcomes

et al. 2010

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“…Yet there is evidence from the literature that there is significant intersurgeon variability for patient outcome in various surgical specialties. Positive effects of subspeciality training and increased patient volume on outcomes have been widely reported for outcomes in colorectal 23 and vascular surgery. 24,25 It appears that trainees can perform to the standard set by the supervising consultant.…”

Section: Discussionmentioning

confidence: 99%

The impact of training on outcomes in primary vascular access surgery

Weale

Barwell²,

Chant³

et al. 2004

Ann R Coll Surg Engl

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Background: There is evidence that the outcome of arteriovenous fistula surgery is dependent on the surgeon performing the operation. Vascular access surgery provides excellent technical training for surgical trainees. The effect of surgical trainees on the outcome of fistulas was evaluated. Methods: The grade of the main operator for all first attempted (primary) upper limb arteriovenous fistulas, between February 1998 and August 2001, was identified. Median follow-up was 18.0 months (IQR, 6.5-30.1 months). Successful use of fistula for dialysis, fistula patency and survival were assessed. Results: 441 primary fistulas were formed in the study period. Median age was 67.5 years (IQR, 54.0-75.2 years). 71% of all fistulas were formed at the wrist. Trainees performed 31.1% of all operations. The two groups (trainees and consultants) were well matched for age, sex, diabetes, and fistula type. Only 70.5% of patients proceeded to long-term haemodialysis. There were no significant differences in the successful use of AVF for dialysis or patency rates between the two groups. One and two year fistula survival in this group was 87.7% and 78.3% for trainees and 80.8% and 71.1% for consultants (P = 0.288 log rank). Conclusions: Surgical trainees can perform primary AVF surgery without significantly reducing fistula outcomes. Vascular access surgery can be utilised as a training operation.

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“…Stocchi et al from the Mayo Clinic also reported a significant decrease in the risk of recurrence of rectal cancer in patients operated on by surgeons who performed more than 10 surgeries within the 5 years of the study (24). Other reports do not confirm the influence of the surgeon's caseload on outcome in rectal cancer (5,25,26,27). Secco et al did not find significant differences in survival and local recurrence rates relative to the experience of the surgeon (26); similar conclusions were published by Kee et al (5).…”

Section: Discussionmentioning

confidence: 97%

Is the Surgeon's Experience an Independent Prognostic Factor in Rectal Cancer?

Kładny

Al-Amawi

Kozłowski

et al. 2007

Polish Journal of Surgery

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The aim of the study was to evaluate the influence of the surgeons' caseload on the results of therapy in rectal cancer. Material and methods. 286 consecutive patients (155 males and 131 females) were enrolled and operated on for rectal cancer stage T2 (112 patients) and T3 (174 patients) in 8 surgical centers of Szczecin between January 1993 and December 1997. Studied group included about 79% of radically operated patients due were to rectal cancer in analyzed period. Results. The patients were assigned to one of two groups with regard to the surgeon's caseload. The first group was comprised of 116 patients (including 72 stage T3 and 54 stage T2 patients) operated on by surgeons more experienced in rectal surgery and the second group was comprised of 160 patients operated on by 36 surgeons with fewer caseloads. The surgeon's experience in rectal surgery was measured by the surgeon's caseload throughout the entire study period. We considered surgeons with greater than 25 cases over the study period experienced. Analysis of survival with regard to the managing center revealed significant differences for stage T3, with 5-year-survival rates ranging from 14% to 60%. Distinct differences were also noted for survival rates in stage T2 (5-year-survival rates ranged from 38% to 86%); however, these differences were not statistically significant. Analysis of the influence of surgeon's caseload on outcomes in rectal cancer revealed a significant influence in stage T3 and a lack of influence in stage T2. Conclusion. The surgeon's experience is an independent prognostic factor for stage T3 rectal cancer patients.

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Surgical specialist registrars can safely perform resections for carcinoma of the rectum

Abstract: Aim: To assess morbidity, mortality and cancer-related outcomes after supervised rectal resection for cancer by surgical specialist registrars (SpRs

Cited by 15 publications

References 8 publications

Introduction of laparoscopic low anterior resection for rectal cancer early during residency: a single institutional study on short-term outcomes

Introduction of laparoscopic low anterior resection for rectal cancer early during residency: a single institutional study on short-term outcomes

The impact of training on outcomes in primary vascular access surgery

Is the Surgeon's Experience an Independent Prognostic Factor in Rectal Cancer?

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