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      A SURGEON'S PERCEPTION OF TOTAL MESORECTAL EXCISION

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      KICKBUSH-THESIS-2017.pdf (1.200Mb)
      Date
      2017-04-21
      Author
      Kickbush, Julie A 1983-
      ORCID
      0000-0002-6955-0479
      Type
      Thesis
      Degree Level
      Masters
      Metadata
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      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.
      Degree
      Master of Science (M.Sc.)
      Department
      Medicine
      Program
      Health Sciences
      Supervisor
      Groot, Gary
      Committee
      DeCoteau, John; Kenyon, Chris; Magee, Fergall; Deobald, Raymond; Colquhoun, Patrick
      Copyright Date
      March 2017
      URI
      http://hdl.handle.net/10388/7812
      Subject
      Rectal cancer, rectal carcinoma, rectal neoplasm, colorectal cancer, colorectal carcinoma, cancer, carcinoma, total mesorectal excision (TME), surgeon perception
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