The impact of a dedicated multidisciplinary team on the management of early XXXX .

@entity1 @entity2558 @entity5 @entity2996 @entity188
AIM: Local excision of early @entity5 (ERCa) offers comparable survival and reduced operative morbidity compared with radical surgery yet it risks an adverse oncological outcome if performed in the wrong setting. This retrospective review considers the impact of the introduction of a specialist Early Rectal Cancer MDT (ERCaMDT) on the investigation and management of ERCa. METHOD: A retrospective comparative cohort study was undertaken. @entity1 with a final diagnosis of @entity2558 @entity5 at our unit were identified for two 12-month periods before and after the introduction of the specialist ERCaMDT. Data on investigations and therapeutic interventions were compared. RESULTS: Nineteen @entity1 from 2006 and 24 from 2011 were included. In 2006, 12 @entity1 underwent @entity2996 and four transrectal ultrasound (TRUS) examination while in 2011, 18 and 20 received @entity2996 ( @entity2996 ) and TRUS. In 2006 four @entity1 underwent incidental ERCa polypectomy with all having a positive resection margin leading to anterior resection. In 2011 only one case with a positive margin following extended EMR was identified. Definitive local excision without subsequent resection occurred in two @entity1 in 2006 and in 16 in 2011. CONCLUSION: The study demonstrates an improvement in pre-operative ERCa staging, a reduction in margin positivity and an increase in the use of local excision following the implementation of a specialist ERCa MDT. The increased detection of @entity188 through screening and surveillance programmes requires further investigation and management. A specialist ERCa MDT will improve management and should be available to all practioners involved with @entity1 with early @entity5 . This article is protected by copyright. All rights reserved.
