Diseases of the colon and rectum · 1994
Effect of the surgeon's specialty interest on the type of resection performed for colorectal cancer.
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Reinbach D H, McGregor J R, Murray G D, O'Dwyer P J
Аннотация
PURPOSE: The aim of this study was to examine the type of resection performed for colorectal cancer by surgeons with a colorectal interest and compare this with the type of resection performed by surgeons with other specialty interests.
METHODS: One hundred sixteen patients had curative surgery performed for primary colorectal cancer over a one-year period by ten surgeons with four different specialty interests.
RESULTS: Surgeons with an interest in colorectal cancer resected twice as much colon (280 mm vs. 130 mm; P > 0.0001, Mann-Whitney U test) and were more likely to remove adjacent clinically involved organs (15 percent vs. 0 percent) for left-sided colon and rectal cancers compared with surgeons with vascular or transplant interests. Surgeons with an interest in gastroenterology performed a resection that was intermediate between the colorectal and other specialty groups for left-sided cancers. Distal resection margins were significantly greater (55 mm vs. 20 mm; P > 0.001) for sigmoid cancers in the colorectal group, but were similar in all groups for rectal cancer. Resection lengths and margins for right-sided cancers were similar in all groups, although the number of lymph nodes retrieved from the mesentery was greater in the colorectal group (13 vs. 7.5; P = 0.08).
CONCLUSION: This study shows a wide variability in the type of resection performed for colorectal cancer and illustrates the need for clinical trials to evaluate the effect of such variability on patient outcome.
METHODS: One hundred sixteen patients had curative surgery performed for primary colorectal cancer over a one-year period by ten surgeons with four different specialty interests.
RESULTS: Surgeons with an interest in colorectal cancer resected twice as much colon (280 mm vs. 130 mm; P > 0.0001, Mann-Whitney U test) and were more likely to remove adjacent clinically involved organs (15 percent vs. 0 percent) for left-sided colon and rectal cancers compared with surgeons with vascular or transplant interests. Surgeons with an interest in gastroenterology performed a resection that was intermediate between the colorectal and other specialty groups for left-sided cancers. Distal resection margins were significantly greater (55 mm vs. 20 mm; P > 0.001) for sigmoid cancers in the colorectal group, but were similar in all groups for rectal cancer. Resection lengths and margins for right-sided cancers were similar in all groups, although the number of lymph nodes retrieved from the mesentery was greater in the colorectal group (13 vs. 7.5; P = 0.08).
CONCLUSION: This study shows a wide variability in the type of resection performed for colorectal cancer and illustrates the need for clinical trials to evaluate the effect of such variability on patient outcome.