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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 7/2014

01-07-2014 | Original Article

Clinical competence in the surgery of rectal cancer: the Italian Consensus Conference

Authors: Piccoli Micaela, Agresta Ferdinando, Trapani Vincenzo, Nigro Casimiro, Pende Vito, Campanile Fabio Cesare, Vettoretto Nereo, Belluco Enrico, Bianchi Pietro Paolo, Cavaliere Davide, Ferulano Giuseppe, La Torre Filippo, Lirici Marco Maria, Rea Roberto, Ricco Gianni, Orsenigo Elena, Barlera Simona, Lettieri Emanuele, Romano Giovanni Maria, on behalf of The Italian Surgical Societies Working Group

Published in: International Journal of Colorectal Disease | Issue 7/2014

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Abstract

Background and aim

The literature continues to emphasize the advantages of treating patients in “high volume” units by “expert” surgeons, but there is no agreed definition of what is meant by either term. In September 2012, a Consensus Conference on Clinical Competence was organized in Rome as part of the meeting of the National Congress of Italian Surgery (I Congresso Nazionale della Chirurgia Italiana: Unità e valore della chirurgia italiana). The aims were to provide a definition of “expert surgeon” and “high-volume facility” in rectal cancer surgery and to assess their influence on patient outcome.

Method

An Organizing Committee (OC), a Scientific Committee (SC), a Group of Experts (E) and a Panel/Jury (P) were set up for the conduct of the Consensus Conference. Review of the literature focused on three main questions including training, “measuring” of quality and to what extent hospital and surgeon volume affects sphincter-preserving procedures, local recurrence, 30-day morbidity and mortality, survival, function, choice of laparoscopic approach and the choice of transanal endoscopic microsurgery (TEM).

Results and conclusion

The difficulties encountered in defining competence in rectal surgery arise from the great heterogeneity of the parameters described in the literature to quantify it. Acquisition of data is difficult as many articles were published many years ago. Even with a focus on surgeon and hospital volume, it is difficult to define their role owing to the variability and the quality of the relevant studies.
Appendix
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Metadata
Title
Clinical competence in the surgery of rectal cancer: the Italian Consensus Conference
Authors
Piccoli Micaela
Agresta Ferdinando
Trapani Vincenzo
Nigro Casimiro
Pende Vito
Campanile Fabio Cesare
Vettoretto Nereo
Belluco Enrico
Bianchi Pietro Paolo
Cavaliere Davide
Ferulano Giuseppe
La Torre Filippo
Lirici Marco Maria
Rea Roberto
Ricco Gianni
Orsenigo Elena
Barlera Simona
Lettieri Emanuele
Romano Giovanni Maria
on behalf of The Italian Surgical Societies Working Group
Publication date
01-07-2014
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Colorectal Disease / Issue 7/2014
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-014-1887-x

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