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International Journal of Colorectal Disease

Published in:

01-05-2013 | Original Article

Surgical training on rectal cancer surgery: do supervised senior residents differ from consultants in outcomes?

Authors: Carlos Pastor, Javier A. Cienfuegos, Jorge Baixauli, Jorge Arredondo, Jesus J. Sola, Carmen Beorlegui, Jose Luis Hernandez-Lizoain

Published in: International Journal of Colorectal Disease | Issue 5/2013

Abstract

Introduction

The present work is a comparative study to investigate the independent effect of tutored senior residents on rectal cancer surgery in an academic university hospital. The variable “surgeon” is held to be a major determinant of outcome following total mesorectal excision (TME) for rectal cancer.

Objective

We hypothesized that TME can be tutored to senior surgical residents without compromising surgical and oncological outcomes.

Methods

Demographics, preoperative characteristics, and surgical data from consecutive patients undergoing elective TME in an academic center over the last decade were retrospectively reviewed from a prospectively collected database. Outcomes were compared in the two cohorts by a principal surgeon (senior resident or staff) and supervised in all cases by a senior colorectal consultant. Association of outcome variables with the type of surgeon was determined by univariate and multivariate analyses and results were corrected by tumor’s height.

Results

A total of 230 patients were treated over the study period; 136 (59 %) surgeries were performed by staff surgeons (group S) and 94 (41 %) by residents (group R). Both groups were comparable except for distance to anal verge; staff surgeons operated on lower tumors and performed a high percentage of coloanal anastomosis. There were no statistical differences between groups in terms of surgical and oncological outcomes when tumors were located over 7 cm from the anal verge.

Conclusions

Rectal surgery can be performed by senior residents with equal results to staff surgeons when there is direct supervision by a senior consultant and when the tumor is located in the mid–upper rectum (>7 cm from the anal verge). For lower tumors, a careful selection must be made as the operation may require a higher level of training.

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Title: Surgical training on rectal cancer surgery: do supervised senior residents differ from consultants in outcomes?
Authors: Carlos Pastor
Javier A. Cienfuegos
Jorge Baixauli
Jorge Arredondo
Jesus J. Sola
Carmen Beorlegui
Jose Luis Hernandez-Lizoain
Publication date: 01-05-2013
Publisher: Springer-Verlag
Published in: International Journal of Colorectal Disease / Issue 5/2013
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-013-1686-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Surgical training on rectal cancer surgery: do supervised senior residents differ from consultants in outcomes?

Abstract

Introduction

Objective

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Objective

Methods

Results

Conclusions

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