Abdelhafeez H. Abdelhafeez, Zachary Morrison, Huma F. Halepota, Brian Hosfield, Lindsey J. Talbot, Andrew J. Murphy, Andrew M. Davidoff
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Data collected included the presence or absence of six components included in standard pediatric oncology NRs. Inclusion rates were calculated as percentages for each component. Due to the small sample, the Fisher's exact test was used for all hypothesis testing.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Seventy primary tumor resections were performed during the study period, as documented by 38 NRs and 32 SRs. All operative reports after October 2023 were SRs. Completeness of tumor resection and specimen naming were consistently documented in NRs (86% and 100%, respectively) and SRs (100% and 100%, respectively). The presence/absence of three components—intraoperative tumor spillage (31%), vascular involvement (31%), and lymph node sampling (26%)—were documented in fewer than a third of the NRs. 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引用次数: 0
摘要
背景:不同的叙述性手术报告(NR)对术中肿瘤学发现的记录差异很大。最近,一个由儿童癌症专家组成的国际小组为儿童癌症手术制定了一份综合手术报告(SR)。本研究的目的是比较 NR 与 SR 中关键术中发现的记录情况:方法:自 2023 年 10 月开始试行机构 SR 后,我们在 2023 年 6 月至 2024 年 3 月期间对儿童肿瘤中心的所有原发性实体瘤手术切除进行了单中心回顾性审查。收集的数据包括是否包含标准儿科肿瘤 NR 中的六项内容。每项内容的纳入率均按百分比计算。由于样本较少,所有假设检验均采用费雪精确检验:根据 38 份 NR 和 32 份 SR 的记录,研究期间共进行了 70 例原发性肿瘤切除术。2023 年 10 月之后的所有手术报告均为 SR。NR(分别为86%和100%)和SR(分别为100%和100%)均记录了肿瘤切除和标本命名的完整性。只有不到三分之一的 NR 记录了肿瘤术中溢出(31%)、血管受累(31%)和淋巴结取样(26%)三项内容的存在/不存在。在记录有/无局部扩散、术中肿瘤溢出、血管受累和淋巴结取样方面,SR 明显优于 NR:结论:采用SR能明显改善对术中重要发现的记录。因此,我们建议在小儿实体瘤手术中使用 SR。
Documentation of critical intraoperative oncologic findings: Synoptic versus narrative operative reports for childhood cancer surgery
Background
Documentation of intraoperative oncologic findings varies greatly across narrative operative reports (NRs). An international panel of childhood cancer experts recently developed a synoptic operative report (SR) for childhood cancer surgeries. The aim of this study was to compare the documentation of critical intraoperative findings in NRs versus SRs.
Methods
A single-center retrospective review of all surgical resections of primary solid tumors at our pediatric oncology center was conducted from June 2023 to March 2024, after an institutional SR was piloted from October 2023 onwards. Data collected included the presence or absence of six components included in standard pediatric oncology NRs. Inclusion rates were calculated as percentages for each component. Due to the small sample, the Fisher's exact test was used for all hypothesis testing.
Results
Seventy primary tumor resections were performed during the study period, as documented by 38 NRs and 32 SRs. All operative reports after October 2023 were SRs. Completeness of tumor resection and specimen naming were consistently documented in NRs (86% and 100%, respectively) and SRs (100% and 100%, respectively). The presence/absence of three components—intraoperative tumor spillage (31%), vascular involvement (31%), and lymph node sampling (26%)—were documented in fewer than a third of the NRs. Documentation of the presence/absence of locoregional spread, intraoperative tumor spillage, vascular involvement, and lymph node sampling was significantly better in SRs than in NRs.
Conclusion
Adoption of SRs significantly improved the documentation of critical intraoperative findings. Thus, we recommend using SRs in pediatric solid tumor surgery.
期刊介绍:
Pediatric Blood & Cancer publishes the highest quality manuscripts describing basic and clinical investigations of blood disorders and malignant diseases of childhood including diagnosis, treatment, epidemiology, etiology, biology, and molecular and clinical genetics of these diseases as they affect children, adolescents, and young adults. Pediatric Blood & Cancer will also include studies on such treatment options as hematopoietic stem cell transplantation, immunology, and gene therapy.