A CRM of 2 mm or less confers a poorer prognosis and patients should be considered for neoadjuvant treatment.

For rectal cancer patients treated without radiotherapy, a DRM of > 10 mm is recommended.

Improved diagnostics and treatment of rectal cancer aiming at better local control and survival have resulted in a significant reduction in the incidence of distant metastases.

Introduction: Box trainers with motion analysis are important add-ons to surgical training and skills assessment outside the operating room, given that they exhibit construct validity. Material and Methods:Four different tasks were tested for construct validity on a new laparoscopic box trainer with integrated motion analysis. Tracking data from the simulator were analyzed for eighteen parameters per task using an in-house software comparing participants with three different experience levels.Results: In total, 10 novices, 22 intermediates and 16 experts enrolled. No or limited significant difference were found for the peg picker and rope race. For the precision cutting task 12 parameters showed significant difference between novices and intermediates, 14 between novices and experts and 1 between intermediates and experts. For the suture task the corresponding results were 1, 15 and 6. Conclusions:The precision cutting and suture task both showed construct validity for many of the parameters. While the precision cutting task distinguished best between novices and the other two groups, the suture task distinguished best between experts and the other two groups.These results show the importance of the timing of an assessment task, and that an assessment task might have limited value if experience levels are not considered.

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