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Learning Curve: The Surgeon as a Prognostic Factor in Colorectal Cancer Surgery

  • Conference paper
Rectal Cancer Treatment

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 165))

Abstract

The individual surgeon is an independent prognostic factor for outcome in colorectal cancer surgery. The surgeon's learning curve is therefore directly related to the patient's outcome. The exact shape of the learning curve, however, is unknown. The present study reviewed supervision, training/teaching, specialization, surgeon's caseload, and hospital's caseload as the five main surgeon- and hospital-related confounding factors for outcome, and examined their influence on the learning curve as well as their interactions and prognostic significance. All five confounding factors were related to outcome. The highest degree of evidence, however, was found for training/teaching (introduction of total mesorectal excision), specialization in colorectal surgery (special interest, board-certification, specialized colorectal cancer units), and the surgeon's caseload. Five surgeon- and hospitalrelated factors directly influence the surgeon's learning curve and are therefore rightly considered predictors of outcome in colorectal cancer surgery. Improvements in supervision, training/teaching, specialization, the surgeon's caseload, and the hospital's caseload will therefore translate into enhanced patient outcome.

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Authors and Affiliations

  1. Department of Visceral and Transplantation Surgery, Inselspital, University of Berne, 3010, Berne, Switzerland

    Pietro Renzulli

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  1. Pietro Renzulli
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  2. Urban T. Laffer
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Editors and Affiliations

  1. Abteilung für Allgemeine, Viszerale, Unfallchirurgie und Poliklinik, Chirurgische Universitätsklinik Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany

    Markus W. Büchler  & Jürgen Weitz  & 

  2. Chirurgie, Krankenhaus Gerresheim, Kliniken der Landeshauptstadt, Gräulinger Straße 120, 40625, Düsseldorf, Germany

    Bernward Ulrich

  3. The Pelican Cancer Foundation, North Hampshire Hospital, Basingstoke, Hampshire, RG24 9NA, UK

    Richard John Heald (OBE, Surgical Director) (OBE, Surgical Director)

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© 2005 Springer-Verlag Berlin Heidelberg

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Renzulli, P., Laffer, U.T. (2005). Learning Curve: The Surgeon as a Prognostic Factor in Colorectal Cancer Surgery. In: Büchler, M.W., Weitz, J., Ulrich, B., Heald, R.J. (eds) Rectal Cancer Treatment. Recent Results in Cancer Research, vol 165. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-27449-9_11

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  • DOI: https://doi.org/10.1007/3-540-27449-9_11

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-23341-1

  • Online ISBN: 978-3-540-27449-0

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