From Insight to Impact: Improving Mesorectal Evaluation Standards through Resident Educational Intervention

Abstract Introduction/Objective The completeness of total mesorectal excision (TME) and involvement of the circumferential radial margin (CRM) significantly impact local recurrence and survival rates in rectal cancer. Accurate gross examination to assess mesorectal status is crucial, not only for patient prognosis but also for evaluating surgical quality. Methods/Case Report We implemented a quality assurance initiative to enhance mesorectal quantification and CRM assessment by pathology trainees. Low anterior resection specimens received between January 2022 and December 2023 were included, with 2022 as the pre-intervention period and 2023 post-intervention. In December 2022, an educational session was conducted, emphasizing rectal resection specimens’ types and the importance of mesorectal and CRM assessment. Periodic reminder emails reinforced these concepts. Results (if a Case Study enter NA) We identified a total of 35 cases in the study: 20 pre-intervention arm and 15 post-intervention arm. Mesorectal quantification and CRM assessment and documentation improved significantly post- education, rising from 70% (14 of 20 cases) to 93% (14 of 15 cases) (p < 0.0001). Conclusion In conclusion, our study underscores the critical role of meticulous gross examination in assessing mesorectal status, serving not only as a prognostic indicator but also in guiding surgical precision and rectal cancer management. Further, our findings emphasize the transformative potential of education-driven interventions in enhancing the quality of mesorectal evaluation, reinforcing the pivotal role of pathologists and pathology trainees in shaping therapeutic strategies and ultimately improving rectal cancer patient care.