ArticleColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland2026
How safe is teaching of highly specialized rectal surgery? A propensity score-matched 10-year cohort study.
Article in Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimThis study aimed to assess the impact of an institutional teaching program of highly specialized rectal procedures on intra- and early postoperative outcomes.
methodsWe performed a retrospective 10-year cohort study of consecutive patients undergoing low anterior resection (LAR) or abdominoperineal resection (APR) for rectal cancer <12 cm from the anal verge or restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) at a tertiary high-volume academic centre (2014-2023). Procedures were classified as expert (consultant-only) or teaching procedures (performed ≥75% by the trainee under direct supervision). Groups were balanced after 1:1 propensity score matching (PSM) for age, sex, BMI, ASA, Charlson index, neoadjuvant therapy and surgical approach. Primary outcomes were intraoperative surgical adverse events (iAEs, defined according to the Classintra classification) and 30-day complications. Multivariable logistic regression identified predictors of morbidity.
resultsA total of 573 surgeries were included (375 expert-led, 198 teaching procedures). After matching, 374 remained (187 per group). IAEs occurred in 16% and 17% of expert-led and teaching procedures, respectively (p = 0.9). Overall morbidity was 43% vs. 46% (p = 0.7); severe complications (Clavien-Dindo ≥ IIIb) occurred in 16% vs. 17% (p = 0.9), while 30-day mortality was 1.1% vs. 0% (p = 0.5). Median length of stay was 8 vs. 7 days (p = 0.6). Reoperation within 30 days occurred in 15.5% in both groups, and readmissions in 16% vs. 10% (p = 0.2). Multivariable analysis revealed high comorbidity indices and immunosuppression as independent risk factors. Robotic surgery was independently associated with lower postoperative morbidity, while teaching was neither associated with overall morbidity (OR 0.60, 95% CI 0.30-1.17) nor severe complications (OR 0.64, 95% CI 0.26-1.48).
conclusionClosely supervised teaching of highly specialized rectal surgery can be safely implemented into clinical practice without increasing perioperative morbidity, supporting the dual mission of surgical proficiency and training of high-volume centres.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.