van de Graaf F W, Lange M M, Menon A G, O'Mahoney P R A, Milsom J W, Lange J F
Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Ann Surg Oncol. 2016 Dec;23(Suppl 5):798-803. doi: 10.1245/s10434-016-5563-y. Epub 2016 Sep 22.
Oncological and functional results after colorectal cancer surgery vary considerably between hospitals and surgeons. At present, the only source of technical information about the surgical procedure is the operative note, which is subjective and omits critical information. This study aimed to evaluate the feasibility of operative video recording in demonstrating both objective information concerning the surgical procedure and surgical quality, as using a systematic approach might improve surgical performance.
From July 2015 through November 2015, patients aged ≥18 years undergoing elective colorectal cancer surgery were prospectively included in a single-institution trial. Video recording of key moments was performed peroperatively and analyzed for adequacy. The study cases were compared with a historic cohort. Video was compared with the operative note using the amount of adequate steps and a scoring system.
This study compared 15 cases to 32 cases from the historic control group. Compared to the written operative note alone, significant differences in availability of information were seen in favor of video as well as using a combination of video plus the operative note (N adequate steps p = .024; p = <.001. Adequacy score: p = .039; p = <.001, both respectively).
Systematic video registration is feasible and seems to improve the availability of essential information after colorectal cancer surgery. In this respect, combining video with a traditional operative note would be the best option. A multicenter international study is being organized to further evaluate the effect of operative video capture on surgical outcomes.
结直肠癌手术后的肿瘤学和功能结果在不同医院和外科医生之间差异很大。目前，关于手术过程的技术信息的唯一来源是手术记录，而手术记录是主观的，并且遗漏了关键信息。本研究旨在评估手术视频记录在展示有关手术过程的客观信息和手术质量方面的可行性，因为采用系统的方法可能会提高手术表现。
从2015年7月至2015年11月，年龄≥18岁接受择期结直肠癌手术的患者被前瞻性纳入一项单机构试验。术中对关键时刻进行视频记录并分析其充分性。将研究病例与一个历史队列进行比较。使用充分步骤的数量和评分系统将视频与手术记录进行比较。
本研究将15例病例与历史对照组的32例病例进行了比较。与单独的书面手术记录相比，在信息可用性方面存在显著差异，视频以及视频加手术记录的组合更具优势（充分步骤数量：p = 0.024；p = <0.001。充分性评分：p = 0.039；p = <0.001，两者分别）。
系统的视频记录是可行的，并且似乎可以提高结直肠癌手术后重要信息的可用性。在这方面，将视频与传统的手术记录相结合将是最佳选择。正在组织一项多中心国际研究，以进一步评估手术视频捕捉对手术结果的影响。
