Kone Lyonell B, Seok David, Kimble Mabel M, Maker Ajay V, Patil Sachin, Mittal Vijay, Jacobs Michael
Department of Hepatopancreatobiliary Surgery, Ascension Providence Hospital/Michigan State University College of Human Medicine, Southfield, MI, USA.
American University of the Caribbean, Pembroke Pines, FL, USA.
Ann Surg Oncol. 2025 Jan;32(1):382-390. doi: 10.1245/s10434-024-16276-8. Epub 2024 Sep 30.
Synoptic operative reports (SORs) are checklists or templates that contain standardized elements of an operation. These elements are associated with standardized inclusion of critical elements of the operative report that translate into numerous potential benefits. Whereas SORs for melanoma, breast, and colorectal cancer surgery have already been widely implemented, similar templates for hepato-pancreato-biliary (HPB) cancer surgery are currently lacking.
An anonymous voluntary online survey was distributed to HPB attendings and fellows at HPB and complex general surgical oncology (CGSO) fellowship programs.
The 54 participants in this study comprised 31 (57%) HPB surgery attendings, 15 (28%) HPB surgery fellows, and 8 (15%) CGSO fellows. Notably, only six (11%) participants reported consistent use of an HPB SOR. The most commonly reported barriers to SOR uptake were the "lack of a readily available template" (55%) and the "lack of consensus/guidelines" (49%). Despite these limiting factors, a majority of respondents indicated a strong willingness to use a standardized and readily available HPB SOR (mean, 4.13/5 ± 1.23). This interest did not differ between attendings and fellows (p = 0.52) or between the participants stratified by surgical experience (p = 0.58). Finally, the participants were provided a comprehensive list of possible elements to incorporate into a standardized pancreatic and hepatobiliary SOR. After the exclusion of elements with less than 75% agreement, the pancreatic SORs included 17 (57%) of 30 possible elements, and the hepatobiliary SORs included 19 (76%) of 25 possible elements.
Broad consensus on several elements of the HPB SOR suggests that uptake should be accelerated in HPB surgery.
概要手术报告（SORs）是包含手术标准化要素的清单或模板。这些要素与手术报告关键要素的标准化纳入相关联，可带来诸多潜在益处。黑色素瘤、乳腺癌和结直肠癌手术的SORs已得到广泛应用，而目前缺乏用于肝胰胆（HPB）癌手术的类似模板。
向HPB及复杂普通外科肿瘤学（CGSO） fellowship项目的HPB主治医师和住院医师发放了一份匿名自愿在线调查问卷。
本研究的54名参与者包括31名（57%）HPB手术主治医师、15名（28%）HPB手术住院医师和8名（15%）CGSO住院医师。值得注意的是，只有6名（11%）参与者报告一直使用HPB SOR。报告的采用SOR的最常见障碍是“缺乏现成模板”（55%）和“缺乏共识/指南”（49%）。尽管存在这些限制因素，但大多数受访者表示强烈愿意使用标准化且现成的HPB SOR（平均分为4.13/5 ± 1.23）。这种意愿在主治医师和住院医师之间（p = 0.52）或按手术经验分层的参与者之间（p = 0.58）没有差异。最后，为参与者提供了一份可能纳入标准化胰腺和肝胆SOR的要素综合清单。在排除共识率低于75%的要素后，胰腺SOR包含30个可能要素中的17个（57%），肝胆SOR包含25个可能要素中的19个（76%）。
HPB SOR若干要素的广泛共识表明，HPB手术应加快采用SOR。
