BACKGROUND AND AIM: The literature continues to emphasize the advantages of treating patients in "high volume" units by "expert" surgeons, but there is no agreed definition of what is meant by either term. In September 2012, a Consensus Conference on Clinical Competence was organized in Rome as part of the meeting of the National Congress of Italian Surgery (I Congresso Nazionale della Chirurgia Italiana: Unità e valore della chirurgia italiana). The aims were to provide a definition of "expert surgeon" and "high-volume facility" in rectal cancer surgery and to assess their influence on patient outcome. METHOD: An Organizing Committee (OC), a Scientific Committee (SC), a Group of Experts (E) and a Panel/Jury (P) were set up for the conduct of the Consensus Conference. Review of the literature focused on three main questions including training, "measuring" of quality and to what extent hospital and surgeon volume affects sphincter-preserving procedures, local recurrence, 30-day morbidity and mortality, survival, function, choice of laparoscopic approach and the choice of transanal endoscopic microsurgery (TEM). RESULTS AND CONCLUSION: The difficulties encountered in defining competence in rectal surgery arise from the great heterogeneity of the parameters described in the literature to quantify it. Acquisition of data is difficult as many articles were published many years ago. Even with a focus on surgeon and hospital volume, it is difficult to define their role owing to the variability and the quality of the relevant studies.
BACKGROUND AND AIM: The literature continues to emphasize the advantages of treating patients in "high volume" units by "expert" surgeons, but there is no agreed definition of what is meant by either term. In September 2012, a Consensus Conference on Clinical Competence was organized in Rome as part of the meeting of the National Congress of Italian Surgery (I Congresso Nazionale della Chirurgia Italiana: Unità e valore della chirurgia italiana). The aims were to provide a definition of "expert surgeon" and "high-volume facility" in rectal cancer surgery and to assess their influence on patient outcome. METHOD: An Organizing Committee (OC), a Scientific Committee (SC), a Group of Experts (E) and a Panel/Jury (P) were set up for the conduct of the Consensus Conference. Review of the literature focused on three main questions including training, "measuring" of quality and to what extent hospital and surgeon volume affects sphincter-preserving procedures, local recurrence, 30-day morbidity and mortality, survival, function, choice of laparoscopic approach and the choice of transanal endoscopic microsurgery (TEM). RESULTS AND CONCLUSION: The difficulties encountered in defining competence in rectal surgery arise from the great heterogeneity of the parameters described in the literature to quantify it. Acquisition of data is difficult as many articles were published many years ago. Even with a focus on surgeon and hospital volume, it is difficult to define their role owing to the variability and the quality of the relevant studies.
Authors: S Trastulli; R Cirocchi; C Listorti; D Cavaliere; N Avenia; N Gullà; G Giustozzi; F Sciannameo; G Noya; C Boselli Journal: Colorectal Dis Date: 2012-06 Impact factor: 3.788
Authors: J Engel; J Kerr; R Eckel; B Günther; M Heiss; W Heitland; J R Siewert; K-W Jauch; D Hölzel Journal: Eur J Surg Oncol Date: 2005-06 Impact factor: 4.424
Authors: Thomas E Read; Robert J Myerson; James W Fleshman; Robert D Fry; Elisa H Birnbaum; Bruce J Walz; Ira J Kodner Journal: Dis Colon Rectum Date: 2002-07 Impact factor: 4.585
Authors: Douglas K Rex; Andrew J Overhiser; Shawn C Chen; Oscar W Cummings; Thomas M Ulbright Journal: Am J Gastroenterol Date: 2009-01 Impact factor: 10.864
Authors: G Lezoche; M Baldarelli; Mario Guerrieri; A M Paganini; A De Sanctis; S Bartolacci; E Lezoche Journal: Surg Endosc Date: 2007-10-18 Impact factor: 4.584