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Erschienen in: Journal of Gastrointestinal Surgery 10/2009

01.10.2009 | Editorial

Complete Mesocolic Excision—A Marker of Surgical Quality?

verfasst von: Aisling M. Hogan, Des C. Winter

Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 10/2009

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Excerpt

Quality assurance in surgery has never been more important. As public awareness and lay access to educational resources increase, the onus is on the surgical community to provide a consistently excellent standard of care. Nowhere is this more evident than the field of oncology. The establishment of the multidisciplinary care model ensures that patients are afforded timely and appropriate specialist referral,1 and an international vogue towards a patient-led service is evident in recent years.2 While involvement of chemo- and radiation-oncologists undoubtedly improves disease-free survival, there is an increasing body of evidence pointing to the primacy of surgical technique.3 Natural evolution of practice produced enhanced results,4 but a more active approach to establishment of guidelines and implementation of strict protocols has been adopted.5 The concept of variation in outcome dependent upon the individual surgeon performing the operation is not new6 but certainly adds weight to the argument for subspecialization in the light of the ongoing volume-outcome debate.7
Literatur
4.
5.
Zurück zum Zitat Kline RW, Smith AR, Coia LR, Owen JB, Hanlon A, Wallace M, Hanks G. Treatment planning for adenocarcinoma of the rectum and sigmoid: a patterns of care study. PCS Committee. Int J Radiat Oncol Biol Phys 1997;37(2):305–311.PubMed Kline RW, Smith AR, Coia LR, Owen JB, Hanlon A, Wallace M, Hanks G. Treatment planning for adenocarcinoma of the rectum and sigmoid: a patterns of care study. PCS Committee. Int J Radiat Oncol Biol Phys 1997;37(2):305–311.PubMed
6.
8.
Zurück zum Zitat Heald RJ. The “Holy Plane” of rectal surgery. J R Soc Med 1988;81:503–508.PubMed Heald RJ. The “Holy Plane” of rectal surgery. J R Soc Med 1988;81:503–508.PubMed
9.
Zurück zum Zitat Wang C, Zhou ZG, Yu YY, Shu Y, Li Y, Yang L, Li L. Occurrence and prognostic value of circumferential resection margin involvement for patients with rectal cancer. Int J Colorectal Dis 2009;24(4):385–390. doi:10.1007/s00384-008-0624-8.PubMedCrossRef Wang C, Zhou ZG, Yu YY, Shu Y, Li Y, Yang L, Li L. Occurrence and prognostic value of circumferential resection margin involvement for patients with rectal cancer. Int J Colorectal Dis 2009;24(4):385–390. doi:10.​1007/​s00384-008-0624-8.PubMedCrossRef
10.
Zurück zum Zitat Quirke P, Steele R, Monson J, Grieve R, Khanna S, Couture J, O'Callaghan C, Myint AS, Bessell E, Thompson LC, Parmar M, Stephens RJ, Sebag-Montefiore D, MRC CR07/NCIC-CTG CO16 Trial Investigators; NCRI Colorectal Cancer Study Group. Effect of the plane of surgery achieved on local recurrence in patients with operable rectal cancer: a prospective study using data from the MRC CR07 and NCIC-CTG CO16 randomised clinical trial. Lancet 2009;373(9666):821–828. doi:10.1016/S0140-6736(09)60485-2.PubMedCrossRef Quirke P, Steele R, Monson J, Grieve R, Khanna S, Couture J, O'Callaghan C, Myint AS, Bessell E, Thompson LC, Parmar M, Stephens RJ, Sebag-Montefiore D, MRC CR07/NCIC-CTG CO16 Trial Investigators; NCRI Colorectal Cancer Study Group. Effect of the plane of surgery achieved on local recurrence in patients with operable rectal cancer: a prospective study using data from the MRC CR07 and NCIC-CTG CO16 randomised clinical trial. Lancet 2009;373(9666):821–828. doi:10.​1016/​S0140-6736(09)60485-2.PubMedCrossRef
12.
Zurück zum Zitat Kube R, Ptok H, Wolff S, Lippert H, Gastinger I, Study Group Colon/Rectum Carcinoma. (Primary Tumour). Quality of medical care in colorectal cancer in Germany. Onkologie 2009;32(1–2):25–29. doi:10.1159/000185572.PubMedCrossRef Kube R, Ptok H, Wolff S, Lippert H, Gastinger I, Study Group Colon/Rectum Carcinoma. (Primary Tumour). Quality of medical care in colorectal cancer in Germany. Onkologie 2009;32(1–2):25–29. doi:10.​1159/​000185572.PubMedCrossRef
13.
Zurück zum Zitat Rim SH, Seeff L, Ahmed F, King JB, Coughlin SS. Colorectal cancer incidence in the United States, 1999–2004: an updated analysis of data from the National Program of Cancer Registries and the Surveillance, Epidemiology, and End Results Program. Cancer 2009;115(9):1967–1976.PubMedCrossRef Rim SH, Seeff L, Ahmed F, King JB, Coughlin SS. Colorectal cancer incidence in the United States, 1999–2004: an updated analysis of data from the National Program of Cancer Registries and the Surveillance, Epidemiology, and End Results Program. Cancer 2009;115(9):1967–1976.PubMedCrossRef
14.
Zurück zum Zitat Baxter NN. Is lymph node count an ideal quality indicator for cancer care? J Surg Oncol 2009;99(4):265–268.PubMedCrossRef Baxter NN. Is lymph node count an ideal quality indicator for cancer care? J Surg Oncol 2009;99(4):265–268.PubMedCrossRef
16.
Zurück zum Zitat Wright FC, Law CH, Berry S, Smith AJ. Clinically important aspects of lymph node assessment in colon cancer. J Surg Oncol 2009;99(4):248–255.PubMedCrossRef Wright FC, Law CH, Berry S, Smith AJ. Clinically important aspects of lymph node assessment in colon cancer. J Surg Oncol 2009;99(4):248–255.PubMedCrossRef
17.
Zurück zum Zitat Dillman RO, Aaron K, Heinemann FS, McClure SE. Identification of 12 or more lymph nodes in resected colon cancer specimens as an indicator of quality performance. Cancer 2009;115(9):1840–1848.PubMedCrossRef Dillman RO, Aaron K, Heinemann FS, McClure SE. Identification of 12 or more lymph nodes in resected colon cancer specimens as an indicator of quality performance. Cancer 2009;115(9):1840–1848.PubMedCrossRef
20.
Zurück zum Zitat Larson DW, Marcello PW, Larach SW, Wexner SD, Park A, Marks J, Senagore AJ, Thorson AG, Young-Fadok TM, Green E, Sargent DJ, Nelson H. Surgeon volume does not predict outcomes in the setting of technical credentialing: results from a randomized trial in colon cancer. Ann Surg 2008;248(5):746–750. doi:10.1097/SLA.0b013e31818a157d.PubMedCrossRef Larson DW, Marcello PW, Larach SW, Wexner SD, Park A, Marks J, Senagore AJ, Thorson AG, Young-Fadok TM, Green E, Sargent DJ, Nelson H. Surgeon volume does not predict outcomes in the setting of technical credentialing: results from a randomized trial in colon cancer. Ann Surg 2008;248(5):746–750. doi:10.​1097/​SLA.​0b013e31818a157d​.PubMedCrossRef
23.
Zurück zum Zitat Hysong SJ. Meta-analysis: audit and feedback features impact effectiveness on care quality. Med Care 2009;47(3):356–363.PubMedCrossRef Hysong SJ. Meta-analysis: audit and feedback features impact effectiveness on care quality. Med Care 2009;47(3):356–363.PubMedCrossRef
25.
Zurück zum Zitat Chao HH, Schwartz AR, Hersh J, Hunnibell L, Jackson GL, Provenzale DT, Schlosser J, Stapleton LM, Zullig LL, Rose MG. Improving colorectal cancer screening and care in the veterans affairs healthcare system. Clin Colorectal Cancer 2009;8(1):22–28. doi:10.3816/CCC.2009.n.004.PubMedCrossRef Chao HH, Schwartz AR, Hersh J, Hunnibell L, Jackson GL, Provenzale DT, Schlosser J, Stapleton LM, Zullig LL, Rose MG. Improving colorectal cancer screening and care in the veterans affairs healthcare system. Clin Colorectal Cancer 2009;8(1):22–28. doi:10.​3816/​CCC.​2009.​n.​004.PubMedCrossRef
26.
Zurück zum Zitat Fraser-Hill M, Walsh C, Seppala R, Tao H, Stein L. Computed tomography colonography: the future of colon cancer screening. Can Assoc Radiol J 2008;59(4):191–196.PubMed Fraser-Hill M, Walsh C, Seppala R, Tao H, Stein L. Computed tomography colonography: the future of colon cancer screening. Can Assoc Radiol J 2008;59(4):191–196.PubMed
28.
Zurück zum Zitat West NP, Morris EJ, Rotimi O, Cairns A, Finan PJ, Quirke P. Pathology grading of colon cancer surgical resection and its association with survival: a retrospective observational study. Lancet Oncol 2008;9(9):857–865. doi:10.1016/S1470-2045(08)70181-5.PubMedCrossRef West NP, Morris EJ, Rotimi O, Cairns A, Finan PJ, Quirke P. Pathology grading of colon cancer surgical resection and its association with survival: a retrospective observational study. Lancet Oncol 2008;9(9):857–865. doi:10.​1016/​S1470-2045(08)70181-5.PubMedCrossRef
29.
Zurück zum Zitat Hohenberger W, Weber K, Matzel K, Papadopoulos T, Merkel S. Standardized surgery for colonic cancer: complete mesocolic excision and central ligation—technical notes and outcome. Colorectal Dis 2009;11(4):354–364PubMedCrossRef Hohenberger W, Weber K, Matzel K, Papadopoulos T, Merkel S. Standardized surgery for colonic cancer: complete mesocolic excision and central ligation—technical notes and outcome. Colorectal Dis 2009;11(4):354–364PubMedCrossRef
30.
Zurück zum Zitat Washington MK. Colorectal carcinoma: selected issues in pathologic examination and staging and determination of prognostic factors. Arch Pathol Lab Med 2008;132(10):1600–607.PubMed Washington MK. Colorectal carcinoma: selected issues in pathologic examination and staging and determination of prognostic factors. Arch Pathol Lab Med 2008;132(10):1600–607.PubMed
Metadaten
Titel
Complete Mesocolic Excision—A Marker of Surgical Quality?
verfasst von
Aisling M. Hogan
Des C. Winter
Publikationsdatum
01.10.2009
Verlag
Springer-Verlag
Erschienen in
Journal of Gastrointestinal Surgery / Ausgabe 10/2009
Print ISSN: 1091-255X
Elektronische ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-009-0976-6

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