scholarly journals Grading quality of total mesorectal excision specimen by surgeons

2018 ◽  
Vol 6 (2) ◽  
pp. 69-73
Author(s):  
Dhiresh Kumar Maharjan ◽  
Prabin Bikram Thapa
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Anterior Resection ◽  
College Teaching ◽  
Mesorectal Excision ◽  
Good Tool ◽  
Photographic Documentation ◽  
Photo Documentation ◽  
Operating Surgeon

Background: Total mesorectal excision has been gold standard since 1978. But standardization of surgery with quality assurance of total mesorectal excision specimen has been a challenging issue in developing countries. However, quality of macroscopic total mesorectal excision can be graded immediately by operating surgeon before specimen has been fixed in formalin and photographic documentation of gross specimen by surgeons is possible and practical.Objective: To grade macroscopic total mesorectal excision specimen by surgeon and document it photographically and compare it with reporting received from pathologist. Methods: A prospective observational study conducted from Jan 2014 to Jan 2016 at Department of Surgery, Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal. All consecutive patients with rectal cancer (upper/middle and lower) without distant metastasis were included. Immediate after surgery, macroscopic specimen of TME were graded by operating surgeon and photo-documentation with one anterior, one posterior and two right and left lateral views of total mesorectal excision photos were taken and documented with printed form along with operative notes.Results: There were 40 patients with rectal cancer who underwent surgery during this period. Among those patients, the median age was 25 years of which 30% were females. Twenty-four patients underwent low anterior resection whereas thirteen had ultralow anterior resection and three had abdominal perineal resection. All patients had photo documentation. Complete mesorectal excision was seen in 36 patients and four patients had near complete total mesorectal excision when graded by surgeons. However, pathologist reported six (16.6%) patients having near complete mesorectum among those which had been graded as complete by surgeons.Conclusion: Grading of macroscopic total mesorectal excision specimen by surgeon is feasible and with use of photographic documentation, it can help to assess the quality of surgeons work and can be a good tool for feedback for surgeons to improve. 

scholarly journals Robotic-Assisted Surgery Improves the Quality of Total Mesorectal Excision for Rectal Cancer Compared to Laparoscopy: Results of a Case–Controlled Analysis

2015 ◽  
Vol 40 (4) ◽  
pp. 1010-1016 ◽  
Author(s):  
Pierre Allemann ◽  
Céline Duvoisin ◽  
Luca Di Mare ◽  
Martin Hübner ◽  
Nicolas Demartines ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Mesorectal Excision ◽  
Robotic Assisted ◽  
Robotic Assisted Surgery

scholarly journals Transanal total mesorectal excision (TaTME) for rectal cancer: effects on patient-reported quality of life and functional outcome

2017 ◽  
Vol 21 (1) ◽  
pp. 25-33 ◽  
Author(s):  
T. W. A. Koedam ◽  
G. H. van Ramshorst ◽  
C. L. Deijen ◽  
A. K. E. Elfrink ◽  
W. J. H. J. Meijerink ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Functional Outcome ◽  
Transanal Total Mesorectal Excision ◽  
Mesorectal Excision ◽  
Patient Reported

scholarly journals Urinary Dysfunction in Women Following Total Mesorectal Excision Vs. Partial Mesorectal Excision for Treatment of Rectal Cancer

2021 ◽  
Author(s):  
Henry H. Chill ◽  
Shani Parnasa ◽  
Noam Shussman ◽  
Roie Alter ◽  
Briggite Helou ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Urinary Dysfunction ◽  
University Hospital ◽  
Mesorectal Excision ◽  
Increased Risk ◽  
The Impact ◽  
Substantial Morbidity

Abstract Background: Colorectal cancer is a condition which is associated with substantial morbidity and mortality. The aim of this study was to assess urinary dysfunction and its effect on quality of life in women who underwent total mesorectal excision compared to women treated by partial mesorectal excision for treatment of rectal cancer. Methods: We performed a retrospective cohort study at a tertiary university hospital between January 2014 and December 2019. A comparison was performed between women who underwent total mesorectal excision as opposed to partial mesorectal excision for treatment of rectal cancer. Pre-operative, intra-operative and post-operative data were compared between groups. Urinary dysfunction and its impact on quality of life were assessed using UDI-6 and USIQ questionnaires. Further univariate and multivariate analyses were performed in the attempt of assessing risk factors for urinary dysfunction. Results: A total of 107 women were included in the study, 73 women underwent partial mesorectal excision as opposed to 34 women who were treated by total mesorectal excision. Urinary dysfunction following surgery as assessed using the UDI-6 questionnaire did not differ between groups. Similar findings were recorded with regard to the impact of urinary dysfunction on quality of life as assessed using the USIQ questionnaire. Following multivariate analysis longer hospital stay was associated with increased risk of some degree of urinary dysfunction. Conclusions: Women undergoing total mesorectal excision have comparable results to partial mesorectal excision with regard to urinary dysfunction.

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