Nationwide standardization of minimally invasive right hemicolectomy for colon cancer and development and validation of a video-based competency assessment tool (the Right study).

Autor:	Grüter AAJ; Department of Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.; Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands., Toorenvliet BR; Department of Surgery, Ikazia Hospital, Rotterdam, The Netherlands., Belgers EHJ; Department of Surgery, Zuyderland Medisch Centrum, Heerlen, The Netherlands., Belt EJT; Department of Surgery, Albert Schweitzer Ziekenhuis, Dordrecht, The Netherlands., van Duijvendijk P; Department of Surgery, Gelre Hospitals, Apeldoorn, The Netherlands., Hoff C; Department of Surgery, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands., Hompes R; Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands., Smits AB; Department of Surgery, St.Antonius Ziekenhuis, Nieuwegein, The Netherlands., van de Ven AWH; Department of Surgery, Flevoziekenhuis, Almere, The Netherlands., van Westreenen HL; Department of Surgery, Isala, Zwolle, The Netherlands., Bonjer HJ; Department of Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands., Tanis PJ; Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.; Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC, Rotterdam, The Netherlands., Tuynman JB; Department of Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	The British journal of surgery [Br J Surg] 2024 Jan 03; Vol. 111 (1).
DOI:	10.1093/bjs/znad404
Abstrakt:	Background: Substantial variation exists when performing a minimally invasive right hemicolectomy (MIRH) due to disparities in training, expertise and differences in implementation of innovations. This study aimed to achieve national consensus on an optimal and standardized MIRH technique for colon cancer and to develop and validate a video-based competency assessment tool (CAT) for MIRH. Method: Statements covering all elements of MIRH were formulated. Subsequently, the Delphi technique was used to reach consensus on a standardized MIRH among 76 colorectal surgeons from 43 different centres. A CAT was developed based on the Delphi results. Nine surgeons assessed the same 12 unedited full-length videos using the CAT, allowing evaluation of the intraclass correlation coefficient (ICC). Results: After three Delphi rounds, consensus (≥80% agreement) was achieved on 23 of the 24 statements. Consensus statements included the use of low intra-abdominal pressure, detailed anatomical outline how to perform complete mesocolic excision with central vascular ligation, the creation of an intracorporeal anastomosis, and specimen extraction through a Pfannenstiel incision using a wound protector. The CAT included seven consecutive steps to measure competency of the MIRH and showed high consistency among surgeons with an overall ICC of 0.923. Conclusion: Nationwide consensus on a standardized and optimized technique of MIRH was reached. The CAT developed showed excellent interrater reliability. These achievements are crucial steps to an ongoing nationwide quality improvement project (the Right study). (© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd.)
Databáze:	MEDLINE
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