Can surgeons accurately self-assess quality of surgery in rectal cancer?: LTP30

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Introduction:Quality of surgery for rectal cancer plays a vital role in treatment outcome. The quality of mesorectal excision is recorded by the pathologist in the minimum cancer dataset for rectal cancer.Aim:The aim of this study was to assess the accuracy of the surgeon's own grading of the mesorectal excision.Method:Consecutive patients who had rectal cancer surgery between 4/2007 and 10/2009 were identified from the pathology database. Full pathology cancer dataset including type of operation, surgeon's own score and pathologist's grading of TME were analysed.Results:Seventy patients (23F:47M) underwent rectal cancer surgery over 30 months. Fifty-seven anterior resections and 13 AP resections were performed. 23/51 specimens had histological TME scores of 3, 22/51 scored 2 and 6/51 scored 1. Surgeon's TME scores were recorded in 27 cases. 20/27 (74%) were in agreement with the histological TME score. Surgeons under-scored in 4/27 (15%) cases and over-scored in 3/27 (11%) cases.Conclusion:Surgeons accurately scored their TME in 74% of cases. It is important for a colorectal surgeon to be able to assess their own quality of surgery, especially in rectal surgery, in order to continue to improve outcomes.

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