The importance of training and education in performing total mesorectal excision in rectal cancer surgery

Abstract

Background/Aim. 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. 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.