Javariah Siddiqui1, Kilian Brown1, Assad Zahid1, Christopher John Young2. 1. Department of Colorectal Surgery, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia. 2. Department of Colorectal Surgery, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; Central Clinical School, University of Sydney, Sydney, New South Wales, Australia. Electronic address: christopher.young@sydney.edu.au.
Abstract
INTRODUCTION: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has gained traction for the management of peritoneal metastases. The number of specialist units globally offering CRS/HIPEC is increasing. The aim of this survey was to assess current practices and barriers to referral for CRS/HIPEC among colorectal surgeons in Australia and New Zealand (ANZ). MATERIALS AND METHODS: An online questionnaire was emailed to members of the Colorectal Surgical Society of Australia and New Zealand (CSSANZ). The survey contained 3 sections: namely; demographics, referral patterns and clinical scenarios. Questions on referral patterns included number of peritoneal metastases patients seen per year and referred to a CRS/HIPEC unit, awareness of such a unit and distance from principle place of practice. Different pathologies referred were also explored, as well as investigations performed. Barriers to referral were also surveyed. RESULTS: The response rate was 28% (83/296). Twenty-five percent received CRS training. Most surgeons (95%) were aware of a CRS/HIPEC unit and had referred to one previously. Thirty-nine percent would refer all patients. Provision of good service and/or relationship with CRS/HIPEC specialist were the main reasons for referring to the nearest unit, followed by accessibility. Major factors preventing referral included extent of peritoneal disease (48%), patient characteristics and comorbidities (44%) and lack of evidence (20%). The most common pathologies referred included colorectal and appendiceal peritoneal metastases and pseudomyxoma peritonei. CONCLUSION: Colorectal specialist awareness of CRS/HIPEC units and accessibility is high. Strategies to improve referring physician/surgeon knowledge on patient selection and indications for CRS/HIPEC should be investigated and instituted to ensure all appropriate patients are referred to specialist units for discussion of suitability.
INTRODUCTION: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has gained traction for the management of peritoneal metastases. The number of specialist units globally offering CRS/HIPEC is increasing. The aim of this survey was to assess current practices and barriers to referral for CRS/HIPEC among colorectal surgeons in Australia and New Zealand (ANZ). MATERIALS AND METHODS: An online questionnaire was emailed to members of the Colorectal Surgical Society of Australia and New Zealand (CSSANZ). The survey contained 3 sections: namely; demographics, referral patterns and clinical scenarios. Questions on referral patterns included number of peritoneal metastasespatients seen per year and referred to a CRS/HIPEC unit, awareness of such a unit and distance from principle place of practice. Different pathologies referred were also explored, as well as investigations performed. Barriers to referral were also surveyed. RESULTS: The response rate was 28% (83/296). Twenty-five percent received CRS training. Most surgeons (95%) were aware of a CRS/HIPEC unit and had referred to one previously. Thirty-nine percent would refer all patients. Provision of good service and/or relationship with CRS/HIPEC specialist were the main reasons for referring to the nearest unit, followed by accessibility. Major factors preventing referral included extent of peritoneal disease (48%), patient characteristics and comorbidities (44%) and lack of evidence (20%). The most common pathologies referred included colorectal and appendiceal peritoneal metastases and pseudomyxoma peritonei. CONCLUSION:Colorectal specialist awareness of CRS/HIPEC units and accessibility is high. Strategies to improve referring physician/surgeon knowledge on patient selection and indications for CRS/HIPEC should be investigated and instituted to ensure all appropriate patients are referred to specialist units for discussion of suitability.
Authors: Akash Sharma; Nguyen Tran Minh Duc; Tai Luu Lam Thang; Nguyen Hai Nam; Sze Jia Ng; Kirellos Said Abbas; Nguyen Tien Huy; Ana Marušić; Christine L Paul; Janette Kwok; Juntra Karbwang; Chiara de Waure; Frances J Drummond; Yoshiyuki Kizawa; Erik Taal; Joeri Vermeulen; Gillian H M Lee; Adam Gyedu; Kien Gia To; Martin L Verra; Évelyne M Jacqz-Aigrain; Wouter K G Leclercq; Simo T Salminen; Cathy Donald Sherbourne; Barbara Mintzes; Sergi Lozano; Ulrich S Tran; Mitsuaki Matsui; Mohammad Karamouzian Journal: J Gen Intern Med Date: 2021-04-22 Impact factor: 6.473
Authors: Thamer A Bin Traiki; Sulaiman A AlShammari; Wadha S AlOtaibi; Shahad N AlAnazi; Mashal M Alnmry; Abdullah M Albdah; Noura S Alhassan Journal: Ann Med Surg (Lond) Date: 2021-06-03