Surgical specialist registrars can safely perform resections for carcinoma of the rectum.
OBJECTIVE
To assess morbidity, mortality and cancer-related outcomes after supervised rectal resection for cancer by surgical specialist registrars (SpRs).


METHODS
A total of 205 consecutive patients (115 male; median age 64 years [range, 24-90 years]) under the care of six consultant surgeons, who underwent elective rectal resection of their rectal cancer between 1995-1999 were studied. The modified Dukes' stages were A in 28 patients (13%), B in 47 (21%), C in 103 (51%), and D in 30 (15%).


RESULTS
Sixty-eight patients (35 males) of mean age 64 years (range, 38-82 years) underwent supervised resection (60 anterior resections. 8 abdomino-perineal resections) by a SpR. Of these, 7 (10%) were modified Dukes' stage A, 16 (22%) stage B, 37 (54%) stage C, and 8 (13%) stage D. Postoperative morbidity (SpRs 32% versus consultants 41%; P = 0.25) and mortality (SpRs 3% versus consultants 6%; P = 0.1) were comparable with consultant outcomes. Local recurrence rates (SpRs 9% versus consultants 9%; P = 0.5) and crude survival (SpRs 64% versus consultants 61%; P = 0.31) were also comparable after a median follow-up of 48 months (range, 24-72 months).


CONCLUSIONS
Operative and cancer-related outcomes are not compromised by supervised SpR resections of rectal cancer in selected patients.
Tytherleigh
Matthew
M
Department of Surgery, Royal Berkshire and Battle Hospitals, Reading, UK.
Wheeler
James
J
Birks
Meg
M
Farouk
Ridzuan
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence / Q000592:standards; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology; D009367:Neoplasm Staging; D016017:Odds Ratio; D011183:Postoperative Complications / Q000209:etiology*; D012004:Rectal Neoplasms / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome