Systematic review and meta-analysis of trainee- versus expert surgeon-performed colorectal resection

Abstract

In selected patients, it is appropriate for supervised trainees to perform colorectal resection.

Reply to Saqib et al.

“…Similar to the meta-analysis published by Kelly et al [2], our results showed no statistical differences after comparing leakage rates between colorectal surgeons, general surgeons and supervised trainees on an unadjusted analysis. In multivariate analysis, however, we did identify the individual surgeon to be a risk factor for anastomotic breakdown, as previous studies have done [3][4][5].…”

“…Regenerative medicine is an emerging medical field which offers alternative therapeutic strategies for many diseases by exploiting the capacity of stem cells to regenerate, with the possibility of treating organ or tissue failure [2]. Continence for stool and flatus is maintained by complex sensory and motor interactions in the anorectum [3] and incontinence occurs when one or more of these…”

Outcomes following laparoscopic rectal cancer resection by supervised trainees

“…In the subset of patients who had a converted procedure with an incision shorter than the shortest open incision, the median postoperative stay was the same as for patients undergoing completed laparoscopic surgery, suggesting they gained benefit from laparoscopy. The study reinforces the considerable evidence that supervised trainees can provide safe and competent colorectal cancer surgery. Notably, it appears to extend this argument for laparoscopic rectal cancer resection, with a highly structured approach to training.…”

Comparison of Open Colorectal Surgeries versus Laparoscopic and Lap Assisted Colorectal Surgeries for Short Term Outcomes in Colorectal Malignancy

“…The post operative complications decrease with increased experience especially of anastamotic leakage, intraabdominal infection and mortality (2,14) . In meta-analyses comparing outcomes in laparoscopic colorectal surgery by Kelly and colleagues, the overall rate of anastomotic leak rate was 2.7% (15) Return of bowel function, duration of hospital stay, post operative assisted ventilation, wound infection rates, incidence of wound dehiscence and return to routine activities were favourable for laparoscopic surgeries as compared to open approach in our study. Laparoscopic rectal surgery is still developing with promising short-term benefit, although depending on the skills and techniques of the surgeon (14) .…”