- Title
- Does a learning curve exist in endorectal two-dimensional ultrasound accuracy?
- Creator
- Morris, O. J.; Draganic, B.; Smith, S.
- Relation
- Techniques in Coloproctology Vol. 15, Issue 3, p. 301-311
- Publisher Link
- http://dx.doi.org/10.1007/s10151-011-0711-7
- Publisher
- Springer Italia Srl
- Resource Type
- journal article
- Date
- 2011
- Description
- Background: Aim of the study was to assess adequacy of Colorectal Surgical Society of Australia and New Zealand (CSSANZ) endorectal ultrasound (ERUS) training and whether a subsequent learning curve exists. Methods: A prospective audit of ERUS for staging rectal cancer by a single surgeon from commencement of consultant practice was performed. Data were recorded in a prospectively maintained database. The audit commenced on completion of CSSANZ training. T- and N-stage were assessed clinically, then by ERUS prior to treatment and finally by histology over 8 years. Results: The results were compared over three time periods: the first a single year, then two three-year periods. Two hundred and seventy-two patients were examined. Two hundred and thirty-three were assessable for T-stage (13 no tumour excision, 26 long course pre-operative radiotherapy) and 142 for N-stage (74 endoanal excision, 17 proximal mesorectum un-assessable). Overall accuracy was 82% for T-stage and 73% for N-stage. Accuracy for T- and N-staging did not change significantly over the three time periods (T: 82.1, 82.3, 81.6%, P = 0.14; N: 83.3, 67.9, 74.2%, P = 0.31). The utility of ERUS was demonstrated by clinical assessment not being possible in 32% of cases and where the two modalities disagreed was correct 82% of the time. Conclusions: Endorectal ultrasound rectal cancer staging is accurate for T-stage. Competency in ERUS can be achieved in the CSSANZ fellowship and accuracy does not improve with further experience. An ERUS accreditation scheme should be established for future trainees.
- Subject
- endosonography; learning; neoplasm staging; rectal neoplasms; training
- Identifier
- http://hdl.handle.net/1959.13/937042
- Identifier
- uon:12478
- Identifier
- ISSN:1123-6337
- Language
- eng
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