Prognostic value of good oncological colorectal surgery is now evaluated by the number of lymphnode dissected, particularly the stadiation of the patients is in strong relation between the number of nodes dissected and the overall survival, especially in stage II.
The aim of the study is to provide an adequate oncological resection for all patients by stimulating surgeons to perform a more extensive bowel resection with finest nodal dissection. In a two years period since 2007 to 2008, to achieve a more extensive lymphectomy and also minimize local recurrence, a minimum of 5 cm in distance of resection margin was arbitrary fixed for colonic cancer. As reported in literature the distal margin for medium rectal cancer was fixed in 4 cm and 2 cm for lowest rectum.
The data collected showed an improvement in the number of patients with more than 5 cm resection margin for colonic cancer raising from 81% in 2006 (before the beginning of the study) to 92,2% in 2007 and 92,4% in 2008. Also the number of patient with more than 12 nodes raised from 94% in 2006, to 98% in 2007 and 100% in 2008. In rectal cancer the results were similar with 81% in 2006, 96% in 2007 and 100% in 2008.
These data suggest that interesting surgeon to perform an extensive and finest surgical dissection permit to join a correct oncological surgery in most patients.
