Complete Mesocolic Excision—A Marker of Surgical Quality?

Excerpt

Quality assurance in surgery has never been more important. As public awareness and lay access to educational resources increase, the onus is on the surgical community to provide a consistently excellent standard of care. Nowhere is this more evident than the field of oncology. The establishment of the multidisciplinary care model ensures that patients are afforded timely and appropriate specialist referral,1 and an international vogue towards a patient-led service is evident in recent years.2 While involvement of chemo- and radiation-oncologists undoubtedly improves disease-free survival, there is an increasing body of evidence pointing to the primacy of surgical technique.3 Natural evolution of practice produced enhanced results,4 but a more active approach to establishment of guidelines and implementation of strict protocols has been adopted.5 The concept of variation in outcome dependent upon the individual surgeon performing the operation is not new6 but certainly adds weight to the argument for subspecialization in the light of the ongoing volume-outcome debate.7 …