The importance of training and education in performing total mesorectal excision in rectal cancer surgery
2017
Introduction: In the last two decades there has been a significant progress
in rectal cancer surgery. Preoperative radiotherapy, the introduction of
staplers and largely improved surgical techniques have greatly contributed to
better treatment outcomes, primarily by reducing the frequency of early
surgical complications and the rate of local recurrence. The aim of this
study was to compare operative and postoperative results in the treatment of
rectal cancer between the two groups of surgeons - those who are closely
engaged in colorectal surgery and those who deal with these issues
sporadically. Material and Methods: A retrospective study on 146 patients who
underwent rectal cancer surgery at the Institute of Oncology in the period
from 01.01.2008. to 31.12.2010. Patients were divided into two groups. The
first group (N1 = 101) consisted of patients operated by trained colorectal
surgeons, and in the second (N2 = 45) there were patients who were operated
on by surgeons without training in TME. Results: Preoperative
chemoradiotherapy was received by 49 (33.56%) patients. Statistically
significant difference between the two groups was noted in the duration of
surgery and the need for blood transfusion during surgery. Anastomotic
leakage occurred in 3 patients from N1 and in 10 patients from group N2.
Seven patients (4.79%) developed local recurrence after surgical treatment.
Significant differences exist in local recurrence rate and anastomotic
leakage rate between compared groups. Conclusion: It is necessary to continue
education and training in surgery for rectal cancer to master new
technologies and surgical techniques and to improve the results of surgical
treatment.
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