Audiovisual Record of Colorectal Surgery Better Than Documentation With Audio Alone

Using video to supplement narrated reporting of colorectal cancer surgery improves the quality and objectivity of the information compared with narrated reporting alone, and adds to the overall availability of necessary intraoperative data, according to results from a recent study by Floyd W. van de Graaf, MD, Department of Surgery, Erasmus MC–University Medical Center Rotterdam, the Netherlands, and colleagues (JAMA Surg. 2019 Jan 23. Epub ahead of print).

“Despite ongoing advances in the field of colorectal surgery, the quality of surgical treatment is still variable. As an intrinsic part of surgical quality, the technical information regarding the surgical procedure is reflected only by the narrative operative report (NR), which has been found to be subjective and regularly omits important information,” said Dr van de Graaf and colleagues.

The purpose of the observational Imaging for Quality Control Trial was to investigate whether systematic video recording (SVR) could improve the quality and safety of colorectal cancer surgery compared with NR alone.

The cases of 113 patients receiving laparoscopic surgery for colorectal cancer between January 12, 2016, and October 30, 2017 at 3 centers in the Netherlands were included in the analysis.

Patients were aged ≥18 years and were case-matched and compared with a historical cohort that only had NR. Overall, 69 (61.1%) of the patients were women, and the mean age was 66.3 years. The surgeons involved were asked to methodically capture predefined key steps of the surgery intraoperatively in short video clips.

Dr van de Graaf and colleagues evaluated the SVRs and NRs for adequacy, defined as “the proportion of key steps with available and sufficient information in the report.” This adequacy was compared between the study and control groups, with the SVR alone and as an adjunct to the NR in the study group versus NR alone in the control group.

A mean of 52.5% of 631 steps were adequately described in the control group with NR alone. In the study group, the adequacy of the SVR (78.5%; P <.001) and SVR combined with NR (85.1%; P <.001) was significantly superior to that of NR alone.

According to Dr van de Graaf and colleagues, a shorter postoperative mean length of stay in favor of the study group was the only significant difference between the 2 study arms that had to do with postoperative and pathologic outcomes (8.0 vs 8.6 days, respectively; P = .03).

“Use of SVR in laparoscopic colorectal cancer surgery as an adjunct to the NR might be superior in documenting important steps of the operation compared with NR alone, adding to the overall availability of necessary intraoperative information and contributing to quality control and objectivity,” Dr van de Graaf and colleagues concluded.—Hina Khaliq