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Colorectal
Members
Dr. Manoj Raval (Chair)
Dr. Peter Blair
Dr. Scott Bloom
Dr. Carl Brown
Dr. Damien Byrne
Dr. Rona Cheifetz
Dr. Noelle Davis
Dr. Peter Doris
Dr. David Hanks
Dr. John Hay
Dr. Ahmer Karimuddin
Dr. Richard Lewis
Dr. John MacFarlane
Dr. Greg McGregor
Dr. James Okamura
Dr. Terry Phang
Dr. Nathan Scheidereit
Dr. Barry Sullivan
Dr. Kenneth Wong
Current Activities
History/Archives
Dr. Terry Phang and his team of researchers (Colleen E McGahan, MSc; Greg McGregor, MD; John K MacFarlane, MD; Carl J Brown, MD; Manoj Raval, MD; Rona Cheifetz, MD; Hagen Kennecke, MD; John H Hay, MD) received The Pennsylvania Society of Colon & Rectal Surgeons Award for the best clinical poster. Their poster "Outcomes Improved after Total Mesorectal Excision (TME) Workshops in British Columbia" was presented at the ASCRS 2008 Annual Meeting and Tripartite Meeting, P280
SON Fall Update
Rectal Cancer Update:
The Last 5cm Distal TME and Beyond
Saturday October 24, 25, 2008
Vancouver, BC
St. Paul's Hospital
2008 Fall Update survey
The Surgical Oncology Network Rectal Cancer Initiative with the cooperation of BC general surgeons has standardized the approach to rectal cancer management in BC. However, our recent province-wide data suggest that there are still important aspects of rectal cancer care that are suboptimal, especially our surgical techniques for cancer in the distal rectum. Thus, we plan on a follow up course on rectal cancer treatment and we are asking your help to design this update course. Please participate in the following survey and help us create a better learning opportunity for everyone.
Preliminary Outcomes After Total Mesorectal Excision (TME) in BC
Outcomes for rectal cancer management in British Columbia (BC) were previously reported for the year 1996 and were proven worse than the reported standard of less than 10% [1-3]. Subsequently, a large Dutch TME study reported benefit from preoperative short course radiation in resectable rectal cancers treated with TME [4]. As a result, in 2002 and 2003, strategies were implemented to improve surgical and pathologic rectal cancer techniques and reporting. Management and initial surgical and pathological outcomes of a cohort of non-metastatic rectal cancer patients referred to the BCCA in the 12 month period immediately following educational workshops are reviewed in this poster.
TME Videos
Click on the below desciption to view the video.
1. TME - Cadaver dissection showing dissection planes between visceral
fascia of mesorectum and parietal fascia of pelvis, and showing pelvic nerves. Commentary on
common questions of dissection.
2. TME - Dr Bill Heald's live OR dissection and excellent commentary.
Improving Rectal Cancer Surgery Outcomes
The group has launched a project involving all general surgeons in British Columbia. The intent is to improve outcomes for patients following rectal cancer surgery. Surgeons throughout BC are being asked to complete a dataform on patients when they have performed rectal cancer. Dr. Phang has been instrumental in teaching total mesorectal excision techniques, which have been shown to improve post surgery outcome. A poster has been created and displayed at various conferences in 2003, which details the success of TME instruction.
If you would like further information about this initiative, please contact Dr. Phang.
Guidelines
The group have developed a guideline for the treatment of low rectal cancers.
TME Instruction
Two sessions of TME instruction have taken place - one at the end of November 2002 and the other in mid September 2003. Knowledge of rectal cancer surgery management was assessed through pre- and post-tests. Knowledge of management increased dramatically 0following the sessions. Photos from the September 2003 course are now available.
Publications
- Phang P, MacFarlane J, Taylor R, Cheifetz R, Davis N, Hay J, et al. Practice patterns and appropriateness of care for rectal cancer management in BC. BCMJ Sept 2003;45(7):324-329 (full article in PDF format available by clicking here)
- Phang PT, Law J, Toy E, Speers C, Paltiel C, Coldman A. Pathology audit of 1996 and 2000 reporting for rectal cancer in BC. BCMJ Sept 2003;45(7):319-323 (full article available in PDF format by clicking here)
- Phang PT, Strack M, Poole B. Proposal to improve rectal outcomes in BC. BCMJ Sept 2003;45(7):330-335 (full article available in PDF format by clicking here)
- Phang P, MacFarlane J, Taylor R, Cheifetz R, Davis N, Hay J, et al. Effect of emergent presentation on outcome from rectal cancer management. Am J Surg 2003;185(5):450-4.
- Richard C, Phang P, McLeod R, Group CAoGSEBRiS. Canadian Association of General Surgeons Evidence Based Reviews in Surgery. 5. Need for preoperative radiation in rectal cancer. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. Can J Surg 2003;46(1):54-6.
- Phang P, MacFarlane J, Taylor R, Cheifetz R, Davis N, Hay J, et al. Effects of positive resection margin and tumour distance from anus on rectal cancer treatment outcomes. American Journal of Surgery 2002;183(5):504-8.
- PT Phang: Editorials - Rectal cancer management in BC. BC Med J 2003, 45: 252-253, 312-313.
D Malfair, JA Brown, PT Phang: Preoperative rectal cancer imaging. BC Med J 2003; 45: 259-261.
- Phang PT, Wong WD: Preoperative evaluation of the rectal cancer patient. Current Therapy in Colon & Rectal Surgery 2nd Ed., Chapter 30.
- Hay J, Shah A. Current adjuvant strategies for rectal cancer management. BC Med J 2003
- Phillips N, Coldman AJ. Computer Simulation of the Effect of Different Colorectal Cancer Screening Strategies for British Columbia. BC Med J 2003
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