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. © 2014 Springer-Verlag.

Clinical competence in the surgery of rectal cancer : The Italian Consensus Conference / M. Piccoli, F. Agresta, V. Trapani, C. Nigro, V. Pende, F. Cesare Campanile, N. Vettoretto, E. Belluco, P.P.C.A. Bianchi, D. Cavaliere, G. Ferulano, F. La Torre, M. Maria Lirici, R. Rea, G. Ricco, E. Orsenigo, S. Barlera, E. Lettieri, G. Maria Romano. - In: INTERNATIONAL JOURNAL OF COLORECTAL DISEASE. - ISSN 0179-1958. - 29:7(2014), pp. 863-875. [10.1007/s00384-014-1887-x]

Clinical competence in the surgery of rectal cancer : The Italian Consensus Conference

Paolo Pietro Bianchi;
2014

Abstract

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. © 2014 Springer-Verlag.
Clinical competence; Guidelines; Quality of life; Rectal cancer; Surgery
Settore MED/18 - Chirurgia Generale
INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
Article (author)
File in questo prodotto:
File Dimensione Formato  
76 Int J Colorectal Dis 2014.pdf

non disponibili

371.22 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Micaela2014_Article_ClinicalCompetenceInTheSurgery.pdf

non disponibili

335.1 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/789651
Citazioni
  • ???jsp.display-item.citation.pmc??? 0
  • Scopus 2
  • ???jsp.display-item.citation.isi??? 3
social impact