[Audited teaching program for the treatment of rectal cancer in Spain: results of the first year].
BACKGROUND
Rectal cancer (RC) is one of the tumors showing the greatest discrepancies in outcomes, both in terms of local recurrence (LR) and survival. In Spain, the overall LR rates are unknown, but several European studies have demonstrated that the introduction of national training programs have decreased these rates and have increased survival. The aim of the present study was to present a descriptive analysis of the first results of a national teaching program in total mesorectal excision (TME).


METHODS
The Spanish Association of Surgeons initiated the organization of the teaching process and its scientific committee was made responsible for selecting the group that started the project, based on multidisciplinary teams that met the established requirements. A database containing all the variables studied was designed.


RESULTS
Over the 1-year period, data on 346 patients with RC were gathered. Of these, the tumor was located in the upper third of the rectum in 109 patients, in the middle third in 150, and in the lower third in 87 patients. Endoanal ultrasonography was performed in 222 patients (64.1%) and magnetic resonance imaging in 237 (68.5%). A total of 313 patients were suitable for surgery; 69.3% underwent open surgery and 30.7% underwent laparoscopy. The conversion rate was 21.9%. Sphincter-preserving surgery was performed in 224 patients (71.5%). Morbidity was 37% and mortality was 3%. The quality of the mesorectum was satisfactory in 76% and unsatisfactory in 7%.


CONCLUSIONS
Based on the results obtained during the first year, we believe that the implementation of a national teaching program on TME is feasible and, moreover, that it would improve surgical outcomes.
Codina-Cazador
Antonio
A
Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario de Girona Dr. J. Trueta, Girona, España. cgd.codinac@htrueta.scs.es
Espín
Eloy
E
Biondo
Sebastiano
S
Luján
Juan
J
de Miguel
Mario
M
Alós
Rafael
R
García-Granero
Eduardo
E
Echeverría-Balda
Aitziber
A
Ortiz
Héctor
H
D003133:Commission on Professional and Hospital Activities / Q000458:organization & administration*; D004493:Education / Q000458:organization & administration*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000473:pathology* / Q000601:surgery*; D012042:Registries; D013030:Spain; D013663:Teaching / Q000379:methods*