A SURGEON'S PERCEPTION OF TOTAL MESORECTAL EXCISION

Abstract

Background: Meticulous rectal cancer surgery is imperative in the treatment of rectal cancer. Total mesorectal excision (TME) is required to decrease local recurrence and improve overall survival after surgical resection of rectal cancer. Purpose: The purpose of this study is to evaluate a surgeon’s perception of TME by asking surgeons to predict the pathology results of surgeries they perform prior to obtaining pathology data. Hypothesis: It is hypothesized that the majority of surgeons are accurately perceiving and performing complete TMEs, during rectal cancer resections. We would like to quantify the accuracy of the surgeon's perception of complete total mesorectal excisions. Objectives: (1) To determine if a surgeon's perception of completeness of excision correlates with pathology data. If so, to quantify the accuracy of the surgeon's perception of complete TMEs.

(2) To determine which factors affected a surgeon's ability to obtain a complete resection.

Patients and methods: A prospective study on all adult rectal cancer patients in Saskatchewan from August 2014 to August 2016, including a total of 16 patients. Results: Data analysis was performed using a kappa agreement calculation. The calculation was performed using a cross tabulation of surgeon prediction of TME as nearly complete or complete versus pathology results of nearly complete, complete or incomplete. There were a total of 16 cases and specimens analyzed. The data demonstrated a kappa value of 0.067 which corresponds with a p-value of 0.733, suggesting poor and non-significant correlation between surgeon prediction of completeness of total mesorectal excision and pathology result.