Development of a reliable surgical quality assurance tool for gastrectomy in oncological trials.
- Resource Type
- Academic Journal
- Authors
- Harris A; Department of Surgery and Cancer, Imperial College London, 7th Floor Commonwealth Building, Hammersmith Hospital, Du Cane Road, London, W12 0HS, UK.; Department of Upper Gastrointestinal Surgery, Barking Havering and Redbridge University Hospitals NHS Trust, London, UK.; Butterworth JB; Department of Surgery and Cancer, Imperial College London, 7th Floor Commonwealth Building, Hammersmith Hospital, Du Cane Road, London, W12 0HS, UK.; Boshier PR; Department of Surgery and Cancer, Imperial College London, 7th Floor Commonwealth Building, Hammersmith Hospital, Du Cane Road, London, W12 0HS, UK.; Mavroveli S; Department of Surgery and Cancer, Imperial College London, 7th Floor Commonwealth Building, Hammersmith Hospital, Du Cane Road, London, W12 0HS, UK.; Vadhwana B; Department of Surgery and Cancer, Imperial College London, 7th Floor Commonwealth Building, Hammersmith Hospital, Du Cane Road, London, W12 0HS, UK.; Peters CJ; Department of Surgery and Cancer, Imperial College London, 7th Floor Commonwealth Building, Hammersmith Hospital, Du Cane Road, London, W12 0HS, UK.; Eom BW; Center for Gastric Cancer, National Cancer Center, Seoul, Republic of Korea.; Yeh CC; Department of Surgery, National Taiwan University Hospital, Taipei City, Taiwan.; Mikhail S; Department of General Surgery, Cairo University, Cairo, Egypt.; Sasako M; Department of Surgery, Yodogawa Christian Hospital, Osaka, Japan.; Kim YW; Center for Gastric Cancer, National Cancer Center, Seoul, Republic of Korea.; Hanna GB; Department of Surgery and Cancer, Imperial College London, 7th Floor Commonwealth Building, Hammersmith Hospital, Du Cane Road, London, W12 0HS, UK. g.hanna@imperial.ac.uk.
- Source
- Publisher: Springer-Verlag Tokyo Country of Publication: Japan NLM ID: 100886238 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1436-3305 (Electronic) Linking ISSN: 14363291 NLM ISO Abbreviation: Gastric Cancer Subsets: MEDLINE
- Subject
- Language
- English
Background: Despite its recognized importance, there is currently no reliable tool for surgical quality assurance (SQA) of gastrectomy in surgical oncology. The aim of this study was to develop an SQA tool for gastrectomy and to apply this tool within the ADDICT Trial in order to assess the extent and completeness of lymphadenectomy.
Methods: The operative steps for D1+ and D2 gastrectomy have been previously described in the literature and ADDICT trial manual. Two researchers also performed fieldwork in the UK and Japan to document key operative steps through photographs and semi-structured interviews with expert surgeons. This provided the steps that were used as the framework for the SQA tool. Sixty-two photographic cases from the ADDICT Trial were rated by three independent surgeons. Generalizability (G) theory determined inter-rater reliability. D-studies examined the effect of varying the number of assessors and photographic series they rated. Chi-square assessed intra-rater reliability, comparing how the individual assessor's responses corresponded to their global rating for extent of lymphadenectomy.
Results: The tool comprised 20 items, including 19 anatomical landmarks and a global rating score. Overall reliability had G-coefficient of 0.557. Internal consistency was measured with a Cronbach's alpha score of 0.869 and Chi-square confirmed intra-rater reliability for each assessor as < 0.05.
Conclusions: A photographic surgical quality assurance tool is presented for gastrectomy. Using this tool, the assessor can reliably determine not only the quality but also the extent of the lymphadenectomy performed based on remaining anatomy rather than the excised specimen.
(© 2024. The Author(s).)