AIM: Adenocarcinoma of the lower rectum is clinically challenging because of the need to choose between a wide excision to achieve oncological clearance, on the one hand, and sphincter conservation to maintain anal function, on the other. The English National Low Rectal Cancer Development Programme (LOREC) was developed under the auspices of the Association of Coloproctology of Great Britain and Ireland and the English National Cancer Action Team to improve the outcome of low rectal cancer in England. METHOD: LOREC was initiated focusing on preoperative imaging, selective neoadjuvant therapy, optimal surgical treatment and detailed pathological assessment of the excised specimen. Its key elements were 1-day multidisciplinary team (MDT) workshops, cadaveric surgical training, surgical mentoring, pathological audit and radiological workshops. RESULTS: Overall, 147 (89.6%) of 164 MDTs from 151 National Health Service (NHS) Trusts (some with two MDTs) in England participated in 15 workshops in Basingstoke or Leeds. In addition, 112 surgeons attended a 1-day cadaveric training programme in Bristol, Newcastle or Nottingham, with the main focus on extralevator abdominoperineal excision and pelvic reconstruction, with input from anatomists and from colorectal and plastic surgeons. CONCLUSION: Optimal staging, selective preoperative chemoradiotherapy and precise surgery were considered as crucial to improve the outcome for patients with low rectal cancer. Colorectal Disease
AIM: Adenocarcinoma of the lower rectum is clinically challenging because of the need to choose between a wide excision to achieve oncological clearance, on the one hand, and sphincter conservation to maintain anal function, on the other. The English National Low Rectal Cancer Development Programme (LOREC) was developed under the auspices of the Association of Coloproctology of Great Britain and Ireland and the English National Cancer Action Team to improve the outcome of low rectal cancer in England. METHOD: LOREC was initiated focusing on preoperative imaging, selective neoadjuvant therapy, optimal surgical treatment and detailed pathological assessment of the excised specimen. Its key elements were 1-day multidisciplinary team (MDT) workshops, cadaveric surgical training, surgical mentoring, pathological audit and radiological workshops. RESULTS: Overall, 147 (89.6%) of 164 MDTs from 151 National Health Service (NHS) Trusts (some with two MDTs) in England participated in 15 workshops in Basingstoke or Leeds. In addition, 112 surgeons attended a 1-day cadaveric training programme in Bristol, Newcastle or Nottingham, with the main focus on extralevator abdominoperineal excision and pelvic reconstruction, with input from anatomists and from colorectal and plastic surgeons. CONCLUSION: Optimal staging, selective preoperative chemoradiotherapy and precise surgery were considered as crucial to improve the outcome for patients with low rectal cancer. Colorectal Disease
Authors: Dean A Harris; Kymberley Thorne; Hayley Hutchings; Saiful Islam; Gail Holland; Olivia Hatcher; Sarah Gwynne; Ian Jenkins; Peter Coyne; Michael Duff; Melanie Feldman; Des C Winter; Simon Gollins; Phil Quirke; Nick West; Gina Brown; Deborah Fitzsimmons; Alan Brown; John Beynon Journal: BMJ Open Date: 2016-11-21 Impact factor: 2.692
Authors: E J A Morris; P J Finan; K Spencer; I Geh; A Crellin; P Quirke; J D Thomas; S Lawton; R Adams; D Sebag-Montefiore Journal: Clin Oncol (R Coll Radiol) Date: 2016-02-28 Impact factor: 4.126
Authors: Sapho Xenia Roodbeen; Marta Penna; Hugh Mackenzie; Miranda Kusters; Andrew Slater; Oliver M Jones; Ian Lindsey; Richard J Guy; Chris Cunningham; Roel Hompes Journal: Surg Endosc Date: 2018-10-22 Impact factor: 4.584