RESUMO
Distal resection margin (DRM) and circumferential resection margin (CRM) are two important considerations in rectal cancer management. Although guidelines recommend a 2 cm DRM, studies have shown that a shorter DRM is adequate, especially in patients receiving neoadjuvant chemoradiation. Standardization of total mesorectal excision has greatly improved quality of CRM. Although more patients are undergoing sphincter-saving procedures, abdominoperineal resection is indicated for very distal tumors, and pelvic exenteration is often necessary for tumors involving pelvic organs.
Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/métodos , Procedimentos Cirúrgicos do Sistema Digestório/normas , Laparoscopia , Recidiva Local de Neoplasia/prevenção & controle , Tratamentos com Preservação do Órgão , Neoplasias Retais/prevenção & controle , Neoplasias Retais/cirurgia , Canal Anal/cirurgia , Anastomose Cirúrgica , Colo/cirurgia , Secções Congeladas , Humanos , Período Intraoperatório , Laparoscopia/métodos , Terapia Neoadjuvante , Estadiamento de Neoplasias , Neoplasia Residual/prevenção & controle , Tratamentos com Preservação do Órgão/métodos , Tratamentos com Preservação do Órgão/normas , Equipe de Assistência ao Paciente , Neoplasias Retais/patologia , Resultado do TratamentoAssuntos
Volvo Intestinal , Doenças do Colo Sigmoide , Colectomia , Humanos , Volvo Intestinal/cirurgiaRESUMO
Background: Graduates of Indian medical schools account for the greatest proportion of non-US born international medical graduates applying to general surgery residency programs.Purpose: Provide information to facilitate fair and holistic review of applicants from Indian medical schools.Research Design: Comprehensive review of the Indian medical education system, including history, regulatory agencies, medical school admission, curriculum, cultural differences, immigration issues, and outcomes after residency.Results: The Indian medical education system is one of the world's oldest. The number of medical schools and graduates continues to increase. Medical school admission criteria are variable. Recent regulatory changes have improved the quality of applicants entering the US. Emphasis on academic performance over volunteerism as well as communication styles differ from US graduates. The success of graduates during and after residency is well documented.Conclusions: Understanding the differences in the US and Indian medical education systems will provide a basis for the fair evaluation of applicants.