Issue: Vojnosanit Pregl 2017; Vol. 74 (No. 4)
The importance of training and education in performing total mesorectal excision in rectal cancer surgery
Authors:
Tomislav Petrović, Vicko Ferenc, Dragana Radovanović, Nemanja Petrović, Milan Ranisavljević, Dejan Lukić
Background/Aim. In the last two decades there has been asignificant 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. Methods. This retrospective
study included 146 patients who had underwent rectal
cancer surgery at the Institute of Oncology of Vojvodina in the
period from January 1, 2008 to December 31, 2010. The patients
were divided into two groups, the group N1 of 101 patients
operated on by trained colorectal surgeons, and the group
N2 of 45 patients operated on by surgeons without training in
totalmesorectal excision (TME). Results. Preoperative
chemoradiotherapy was received by 49 (33.56%) of the patients.
A 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 the group N1 and in 10 patients from the group
N2. Seven (4.79%) of the patients developed local recurrence
after surgical treatment. There were significant differences in
local recurrence rate and anastomotic leakage rate between the
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.
