Floyd W van de Graaf1, Marilyne M Lange2, Jolanda I Spakman3, Wilhelmina M U van Grevenstein4, Daan Lips3, Eelco J R de Graaf5, Anand G Menon5,6, Johan F Lange1,5,6. 1. Department of Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands. 2. Department of Pathology, Free University Medical Center, Amsterdam, the Netherlands. 3. Department of Surgery, Jeroen Bosch Hospitals, Hertogenbosch, the Netherlands. 4. Department of Surgery, University Medical Center Utrecht, Utrecht, the Netherlands. 5. Department of Surgery, IJsselland Hospital, Capelle aan den IJssel, the Netherlands. 6. Department of Surgery, Havenziekenhuis, Rotterdam, the Netherlands.
Abstract
Importance: Despite ongoing advances in the field of colorectal surgery, the quality of surgical treatment is still variable. As an intrinsic part of surgical quality, the technical information regarding the surgical procedure is reflected only by the narrative operative report (NR), which has been found to be subjective and regularly omits important information. Objective: To investigate systematic video recording (SVR) as a potential improvement in quality and safety with regard to important information in colorectal cancer surgery. Design, Setting, and Participants: The Imaging for Quality Control Trial was a prospective, observational cohort study conducted between January 12, 2016, and October 30, 2017, at 3 centers in the Netherlands. The study group consisted of 113 patients 18 years or older undergoing elective laparoscopic surgery for colorectal cancer. These patients were case matched and compared with cases from a historical cohort that received only an NR. Interventions: Among study cases, participating surgeons were requested to systematically capture predefined key steps of the surgical procedure intraoperatively on video in short clips. Main Outcomes and Measures: The SVRs and NRs were analyzed for adequacy with respect to the availability of important information regarding the predefined key steps. Adequacy of the reported information was defined as the proportion of key steps with available and sufficient information in the report. Adequacy of the SVR and NR was compared between the study and control groups, with the SVR alone and as an adjunct to the NR in the study group vs NR alone in the control group. Results: Of the 113 study patients, 69 women (61.1%) were included; mean (SD) age was 66.3 (9.8) years. In the control group, a mean (SD) of 52.5% (18.3%) of 631 steps were adequately described in the NR. In the study group, the adequacy of both the SVR (78.5% [16.5%], P < .001) and a combination of the SVR with NR (85.1% [14.6%], P < .001) was significantly superior to NR alone. The only significant difference between the study and historical control groups regarding postoperative and pathologic outcomes was a shorter postoperative mean (SD) length of stay in favor of the study group (8.0 [7.7] vs 8.6 [6.8] days; P = .03). Conclusions and Relevance: Use of SVR in laparoscopic colorectal cancer surgery as an adjunct to the NR might be superior in documenting important steps of the operation compared with NR alone, adding to the overall availability of necessary intraoperative information and contributing to quality control and objectivity.
Importance: Despite ongoing advances in the field of colorectal surgery, the quality of surgical treatment is still variable. As an intrinsic part of surgical quality, the technical information regarding the surgical procedure is reflected only by the narrative operative report (NR), which has been found to be subjective and regularly omits important information. Objective: To investigate systematic video recording (SVR) as a potential improvement in quality and safety with regard to important information in colorectal cancer surgery. Design, Setting, and Participants: The Imaging for Quality Control Trial was a prospective, observational cohort study conducted between January 12, 2016, and October 30, 2017, at 3 centers in the Netherlands. The study group consisted of 113 patients 18 years or older undergoing elective laparoscopic surgery for colorectal cancer. These patients were case matched and compared with cases from a historical cohort that received only an NR. Interventions: Among study cases, participating surgeons were requested to systematically capture predefined key steps of the surgical procedure intraoperatively on video in short clips. Main Outcomes and Measures: The SVRs and NRs were analyzed for adequacy with respect to the availability of important information regarding the predefined key steps. Adequacy of the reported information was defined as the proportion of key steps with available and sufficient information in the report. Adequacy of the SVR and NR was compared between the study and control groups, with the SVR alone and as an adjunct to the NR in the study group vs NR alone in the control group. Results: Of the 113 study patients, 69 women (61.1%) were included; mean (SD) age was 66.3 (9.8) years. In the control group, a mean (SD) of 52.5% (18.3%) of 631 steps were adequately described in the NR. In the study group, the adequacy of both the SVR (78.5% [16.5%], P < .001) and a combination of the SVR with NR (85.1% [14.6%], P < .001) was significantly superior to NR alone. The only significant difference between the study and historical control groups regarding postoperative and pathologic outcomes was a shorter postoperative mean (SD) length of stay in favor of the study group (8.0 [7.7] vs 8.6 [6.8] days; P = .03). Conclusions and Relevance: Use of SVR in laparoscopic colorectal cancer surgery as an adjunct to the NR might be superior in documenting important steps of the operation compared with NR alone, adding to the overall availability of necessary intraoperative information and contributing to quality control and objectivity.
Authors: Nikki E Kolfschoten; Nicoline J van Leersum; Gea A Gooiker; Perla J Marang van de Mheen; Eric-Hans Eddes; Job Kievit; Ronald Brand; Pieter J Tanis; Willem A Bemelman; Rob A E M Tollenaar; Jeroen Meijerink; Michel W J M Wouters Journal: Ann Surg Date: 2013-05 Impact factor: 12.969
Authors: Alex B Haynes; Thomas G Weiser; William R Berry; Stuart R Lipsitz; Abdel-Hadi S Breizat; E Patchen Dellinger; Teodoro Herbosa; Sudhir Joseph; Pascience L Kibatala; Marie Carmela M Lapitan; Alan F Merry; Krishna Moorthy; Richard K Reznick; Bryce Taylor; Atul A Gawande Journal: N Engl J Med Date: 2009-01-14 Impact factor: 91.245
Authors: Meagan E Wiebe; Lakhbir Sandhu; Julie L Takata; Erin D Kennedy; Nancy N Baxter; Anna R Gagliardi; David R Urbach; Alice C Wei Journal: Can J Surg Date: 2013-10 Impact factor: 2.089
Authors: Michael Zhang; Xiaotian Cheng; Daniel Copeland; Arjun Desai; Melody Y Guan; Gabriel A Brat; Serena Yeung Journal: AMIA Annu Symp Proc Date: 2021-01-25
Authors: Özgür Eryigit; Floyd W van de Graaf; Vincent B Nieuwenhuijs; Meindert N Sosef; Eelco J R de Graaf; Anand G Menon; Marilyne M Lange; Johan F Lange Journal: JAMA Surg Date: 2020-07-01 Impact factor: 14.766
Authors: Lauren R Kennedy-Metz; Pietro Mascagni; Antonio Torralba; Roger D Dias; Pietro Perona; Julie A Shah; Nicolas Padoy; Marco A Zenati Journal: IEEE Trans Med Robot Bionics Date: 2020-11-24