Annals of surgery
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Randomized Controlled Trial Multicenter Study Comparative Study
Surgical Quality Assurance in COLOR III: Standardization and Competency Assessment in a Randomized Controlled Trial.
The aim of this study was to develop an objective and reliable surgical quality assurance system (SQA) for COLOR III, an international multicenter randomized controlled trial (RCT) comparing transanal total mesorectal excision (TaTME) with laparoscopic approach for rectal cancer. ⋯ We described an iterative approach to develop an objective SQA within multicenter RCT. This approach provided standardization, the development of reliable and valid CAT, and the criteria for trial entry and monitoring surgical performance during the trial.
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The aim of this study was to use the concept of benchmarking to establish robust and standardized outcome references after the procedure ALPPS (Associating Liver Partition and Portal Vein Ligation for Staged hepatectomy). ⋯ This benchmark analysis sets key reference values for ALPPS, indicating similar outcome as other types of major hepatectomies. Benchmark cutoffs offer valid tools not only for comparisons with other procedures, but also to assess higher risk groups of patients or different indications than colorectal metastases.
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The aim of this study was to investigate variation in the frequency of resections for colorectal cancer liver metastases across the English NHS. ⋯ This study presents the largest reported population-based analysis of liver resection rates in colorectal cancer patients. Significant variation has been observed in patient and hospital characteristics and the likelihood of patients receiving a liver resection, with the data showing that proximity to a liver resection service is as important a factor as deprivation.
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To explore the determinants of postoperative outcomes of adrenal surgery in order to build a proposition for healthcare improvement. ⋯ High-risk patients should be referred to high-volume centers for adrenal surgery.