Transanal Endoscopic Operation for Benign Rectal Lesions and T1 Carcinoma.

Background And Objectives: Transanal endoscopic operation (TEO) is a minimally invasive technique used for local excision of benign and selected malignant rectal lesions. The purpose of this study was to investigate the feasibility, safety, and oncological outcomes of the procedure and to report the experience in 3 centers.

Methods: Retrospective review of a prospectively collected database was performed of all patients with benign lesions or ≤cT1N0 rectal cancer who underwent TEO with curative intent at 3 Belgian centers (2012 through 2014).

Central mesh failure after laparoscopic IPOM procedure.

Central mesh failure after laparoscopic repair of a ventral hernia is a rare finding. We present a case of a 42-year-old man with clear umbilical hernia recurrence 4 years after IPOM procedure with an oxidized cellulose composite polypropylene mesh, using the double crown technique. Laparoscopy showed that a segment of small intestine herniated through a central defect in the prosthesis.

Risk adjusted benchmarking of abdominoperineal excision for rectal adenocarcinoma in the context of the Belgian PROCARE improvement project.

Objective: The abdominoperineal excision (APE) rate, a quality of care indicator in rectal cancer surgery, has been criticised if not adjusted for confounding factors. This study evaluates variability in APE rate between centres participating in PROCARE, a Belgian improvement initiative, before and after risk adjustment. It also explores the effect of merging the Hartmann resections (HR) rate with that of APE on benchmarking.

Exploring limits for data registration in the context of PROCARE, a quality improvement project on rectal cancer.

Background: A high burden of registration in the context of quality improvement projects may result in registration fatigue.

Methods: Time required for data collection and registration was measured. Quality of care indicators (QCI) were scored and factors for adjusted benchmarking were identified.