Comparison of Systematic Video Documentation with Narrative Operative Report in Colorectal Cancer Surgery

Floyd W. van de Graaf, Marilyne M. Lange, Jolanda I. Spakman, Wilhelmina M. U. van Grevenstein, Daan Lips, Eelco J. R. de Graaf, Anand G. Menon, Johan F. Lange

Research output: Contribution to journalArticleAcademicpeer-review

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.
Original languageEnglish
JournalJAMA Surgery
DOIs
Publication statusE-pub ahead of print - 2019

Cite this

van de Graaf, F. W., Lange, M. M., Spakman, J. I., van Grevenstein, W. M. U., Lips, D., de Graaf, E. J. R., ... Lange, J. F. (2019). Comparison of Systematic Video Documentation with Narrative Operative Report in Colorectal Cancer Surgery. JAMA Surgery. https://doi.org/10.1001/jamasurg.2018.5246
van de Graaf, Floyd W. ; Lange, Marilyne M. ; Spakman, Jolanda I. ; van Grevenstein, Wilhelmina M. U. ; Lips, Daan ; de Graaf, Eelco J. R. ; Menon, Anand G. ; Lange, Johan F. / Comparison of Systematic Video Documentation with Narrative Operative Report in Colorectal Cancer Surgery. In: JAMA Surgery. 2019.
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title = "Comparison of Systematic Video Documentation with Narrative Operative Report in Colorectal Cancer Surgery",
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.",
author = "{van de Graaf}, {Floyd W.} and Lange, {Marilyne M.} and Spakman, {Jolanda I.} and {van Grevenstein}, {Wilhelmina M. U.} and Daan Lips and {de Graaf}, {Eelco J. R.} and Menon, {Anand G.} and Lange, {Johan F.}",
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Comparison of Systematic Video Documentation with Narrative Operative Report in Colorectal Cancer Surgery. / van de Graaf, Floyd W.; Lange, Marilyne M.; Spakman, Jolanda I.; van Grevenstein, Wilhelmina M. U.; Lips, Daan; de Graaf, Eelco J. R.; Menon, Anand G.; Lange, Johan F.

In: JAMA Surgery, 2019.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Comparison of Systematic Video Documentation with Narrative Operative Report in Colorectal Cancer Surgery

AU - van de Graaf, Floyd W.

AU - Lange, Marilyne M.

AU - Spakman, Jolanda I.

AU - van Grevenstein, Wilhelmina M. U.

AU - Lips, Daan

AU - de Graaf, Eelco J. R.

AU - Menon, Anand G.

AU - Lange, Johan F.

PY - 2019

Y1 - 2019

N2 - 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.

AB - 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.

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DO - 10.1001/jamasurg.2018.5246

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JO - JAMA Surgery

JF - JAMA Surgery

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