Implementation of a strategic preoperative surgical meeting to improve the level of care at a high-volume pancreatic center: a before–after analysis of 1000 consecutive cases

The indication, planning, and risk analysis of a pancreatic surgical procedure have recently become increasingly complex. In December 2015, the “Pancreas Round” (PR) meeting was established at our institution to preoperatively review all scheduled cases with a specific focus on surgical indications...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Updates in Surgery 2020-03, Vol.72 (1), p.155-161
Hauptverfasser: Surci, Niccolò, Ramera, Marco, Borin, Alex, Marchegiani, Giovanni, Salvia, Roberto, Bassi, Claudio
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 161
container_issue 1
container_start_page 155
container_title Updates in Surgery
container_volume 72
creator Surci, Niccolò
Ramera, Marco
Borin, Alex
Marchegiani, Giovanni
Salvia, Roberto
Bassi, Claudio
description The indication, planning, and risk analysis of a pancreatic surgical procedure have recently become increasingly complex. In December 2015, the “Pancreas Round” (PR) meeting was established at our institution to preoperatively review all scheduled cases with a specific focus on surgical indications and technical issues. The present study aims to determine the impact of the PR on the clinical practice in terms of avoiding unrequested laparotomies and anticipating intraoperative pitfalls. A “before–after” study was conducted by retrospectively comparing a pre-intervention period (9/2014–11/2015) to a prospectively assessed post-intervention one (12/2015–3/2017). Outcomes considered were explorative laparotomy (EL) occurrence and a “mismatch” between what was preoperatively expected by the PR and what was intraoperatively found. Of the 1057 patients included in the present study, 531 underwent surgery in the pre- and 526 in the post-intervention period, respectively. The EL rate was comparable between the two periods (15.4% vs. 12.2%, p  = 0.123), despite the significant increase of surgical explorations after neoadjuvant chemotherapy during the post-intervention period (27% vs. 18%, p  
doi_str_mv 10.1007/s13304-020-00707-8
format Article
fullrecord <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2352053441</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A710618611</galeid><sourcerecordid>A710618611</sourcerecordid><originalsourceid>FETCH-LOGICAL-c414t-8ccfec35522b628382d7305f5b5baf20832a39c1d59d6f62783a714a62fed8d23</originalsourceid><addsrcrecordid>eNp9Uctq3TAQNaWhCUl-oIuiZTdO9fBDt7sQ-ggEsmmhOyHLI18F2XIl-UJ2-Yf-SL-pX9JxfJtlJZA0M2fOaOYUxVtGrxil7YfEhKBVSTkt0aRtKV8VZ5wKWQrB-Ovjmwn247S4TOmB4hK79XxTnApOeSN28qz4fTvOHkaYss4uTCRYoknKUWcYnCFzhDADWu4AJC0RfdqTESC7aSA5EDfOMWAs74F4OIBfGYyOQHRGpr0b9uUh-GUEMuvJREAqQwzWg_gRAR3YEOHP0y9t0UP0pP1jcmllwTYpMWFKYJbn-kYnSBfFidU-weXxPi--f_707eZreXf_5fbm-q40FatyKY2xYERdc941XArJ-1bQ2tZd3WnLqRRci51hfb3rG9vwVgrdsko33EIvey7Oi_cbL_b3c4GU1eiSAe_1BGFJioua01pUFUPo1QYdtAflJhtwfgZ3D6PDBsA69F-3jDZMNmxN4FuCiSGlCFbN0Y06PipG1aqu2tRVqK56VldJTHp3_NDSjdC_pPzTEgFiAyQMTQNE9RCWiANN_6P9C7-Nsq0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2352053441</pqid></control><display><type>article</type><title>Implementation of a strategic preoperative surgical meeting to improve the level of care at a high-volume pancreatic center: a before–after analysis of 1000 consecutive cases</title><source>SpringerNature Journals</source><creator>Surci, Niccolò ; Ramera, Marco ; Borin, Alex ; Marchegiani, Giovanni ; Salvia, Roberto ; Bassi, Claudio</creator><creatorcontrib>Surci, Niccolò ; Ramera, Marco ; Borin, Alex ; Marchegiani, Giovanni ; Salvia, Roberto ; Bassi, Claudio ; SPaRo Group ; SPaRo Group</creatorcontrib><description>The indication, planning, and risk analysis of a pancreatic surgical procedure have recently become increasingly complex. In December 2015, the “Pancreas Round” (PR) meeting was established at our institution to preoperatively review all scheduled cases with a specific focus on surgical indications and technical issues. The present study aims to determine the impact of the PR on the clinical practice in terms of avoiding unrequested laparotomies and anticipating intraoperative pitfalls. A “before–after” study was conducted by retrospectively comparing a pre-intervention period (9/2014–11/2015) to a prospectively assessed post-intervention one (12/2015–3/2017). Outcomes considered were explorative laparotomy (EL) occurrence and a “mismatch” between what was preoperatively expected by the PR and what was intraoperatively found. Of the 1057 patients included in the present study, 531 underwent surgery in the pre- and 526 in the post-intervention period, respectively. The EL rate was comparable between the two periods (15.4% vs. 12.2%, p  = 0.123), despite the significant increase of surgical explorations after neoadjuvant chemotherapy during the post-intervention period (27% vs. 18%, p  &lt; 0.001). The “mismatch” rate between preoperative planning and intraoperative findings was significantly reduced in the post-intervention period (12.2% vs. 8.4%, p  = 0.038) compared to the pre-PR period. In the setting of a high-volume center, a preoperative surgical meeting designed to review all cases scheduled for surgical exploration can enhance the level of care by addressing intraoperative pitfalls.</description><identifier>ISSN: 2038-131X</identifier><identifier>EISSN: 2038-3312</identifier><identifier>DOI: 10.1007/s13304-020-00707-8</identifier><identifier>PMID: 32026398</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Medical research ; Medicine ; Medicine &amp; Public Health ; Medicine, Experimental ; Original Article ; Risk assessment ; Surgery</subject><ispartof>Updates in Surgery, 2020-03, Vol.72 (1), p.155-161</ispartof><rights>Italian Society of Surgery (SIC) 2020</rights><rights>COPYRIGHT 2020 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c414t-8ccfec35522b628382d7305f5b5baf20832a39c1d59d6f62783a714a62fed8d23</citedby><cites>FETCH-LOGICAL-c414t-8ccfec35522b628382d7305f5b5baf20832a39c1d59d6f62783a714a62fed8d23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s13304-020-00707-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s13304-020-00707-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32026398$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Surci, Niccolò</creatorcontrib><creatorcontrib>Ramera, Marco</creatorcontrib><creatorcontrib>Borin, Alex</creatorcontrib><creatorcontrib>Marchegiani, Giovanni</creatorcontrib><creatorcontrib>Salvia, Roberto</creatorcontrib><creatorcontrib>Bassi, Claudio</creatorcontrib><creatorcontrib>SPaRo Group</creatorcontrib><creatorcontrib>SPaRo Group</creatorcontrib><title>Implementation of a strategic preoperative surgical meeting to improve the level of care at a high-volume pancreatic center: a before–after analysis of 1000 consecutive cases</title><title>Updates in Surgery</title><addtitle>Updates Surg</addtitle><addtitle>Updates Surg</addtitle><description>The indication, planning, and risk analysis of a pancreatic surgical procedure have recently become increasingly complex. In December 2015, the “Pancreas Round” (PR) meeting was established at our institution to preoperatively review all scheduled cases with a specific focus on surgical indications and technical issues. The present study aims to determine the impact of the PR on the clinical practice in terms of avoiding unrequested laparotomies and anticipating intraoperative pitfalls. A “before–after” study was conducted by retrospectively comparing a pre-intervention period (9/2014–11/2015) to a prospectively assessed post-intervention one (12/2015–3/2017). Outcomes considered were explorative laparotomy (EL) occurrence and a “mismatch” between what was preoperatively expected by the PR and what was intraoperatively found. Of the 1057 patients included in the present study, 531 underwent surgery in the pre- and 526 in the post-intervention period, respectively. The EL rate was comparable between the two periods (15.4% vs. 12.2%, p  = 0.123), despite the significant increase of surgical explorations after neoadjuvant chemotherapy during the post-intervention period (27% vs. 18%, p  &lt; 0.001). The “mismatch” rate between preoperative planning and intraoperative findings was significantly reduced in the post-intervention period (12.2% vs. 8.4%, p  = 0.038) compared to the pre-PR period. In the setting of a high-volume center, a preoperative surgical meeting designed to review all cases scheduled for surgical exploration can enhance the level of care by addressing intraoperative pitfalls.</description><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Medicine, Experimental</subject><subject>Original Article</subject><subject>Risk assessment</subject><subject>Surgery</subject><issn>2038-131X</issn><issn>2038-3312</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9Uctq3TAQNaWhCUl-oIuiZTdO9fBDt7sQ-ggEsmmhOyHLI18F2XIl-UJ2-Yf-SL-pX9JxfJtlJZA0M2fOaOYUxVtGrxil7YfEhKBVSTkt0aRtKV8VZ5wKWQrB-Ovjmwn247S4TOmB4hK79XxTnApOeSN28qz4fTvOHkaYss4uTCRYoknKUWcYnCFzhDADWu4AJC0RfdqTESC7aSA5EDfOMWAs74F4OIBfGYyOQHRGpr0b9uUh-GUEMuvJREAqQwzWg_gRAR3YEOHP0y9t0UP0pP1jcmllwTYpMWFKYJbn-kYnSBfFidU-weXxPi--f_707eZreXf_5fbm-q40FatyKY2xYERdc941XArJ-1bQ2tZd3WnLqRRci51hfb3rG9vwVgrdsko33EIvey7Oi_cbL_b3c4GU1eiSAe_1BGFJioua01pUFUPo1QYdtAflJhtwfgZ3D6PDBsA69F-3jDZMNmxN4FuCiSGlCFbN0Y06PipG1aqu2tRVqK56VldJTHp3_NDSjdC_pPzTEgFiAyQMTQNE9RCWiANN_6P9C7-Nsq0</recordid><startdate>20200301</startdate><enddate>20200301</enddate><creator>Surci, Niccolò</creator><creator>Ramera, Marco</creator><creator>Borin, Alex</creator><creator>Marchegiani, Giovanni</creator><creator>Salvia, Roberto</creator><creator>Bassi, Claudio</creator><general>Springer International Publishing</general><general>Springer</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IAO</scope><scope>7X8</scope></search><sort><creationdate>20200301</creationdate><title>Implementation of a strategic preoperative surgical meeting to improve the level of care at a high-volume pancreatic center: a before–after analysis of 1000 consecutive cases</title><author>Surci, Niccolò ; Ramera, Marco ; Borin, Alex ; Marchegiani, Giovanni ; Salvia, Roberto ; Bassi, Claudio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c414t-8ccfec35522b628382d7305f5b5baf20832a39c1d59d6f62783a714a62fed8d23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Medicine, Experimental</topic><topic>Original Article</topic><topic>Risk assessment</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Surci, Niccolò</creatorcontrib><creatorcontrib>Ramera, Marco</creatorcontrib><creatorcontrib>Borin, Alex</creatorcontrib><creatorcontrib>Marchegiani, Giovanni</creatorcontrib><creatorcontrib>Salvia, Roberto</creatorcontrib><creatorcontrib>Bassi, Claudio</creatorcontrib><creatorcontrib>SPaRo Group</creatorcontrib><creatorcontrib>SPaRo Group</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale Academic OneFile</collection><collection>MEDLINE - Academic</collection><jtitle>Updates in Surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Surci, Niccolò</au><au>Ramera, Marco</au><au>Borin, Alex</au><au>Marchegiani, Giovanni</au><au>Salvia, Roberto</au><au>Bassi, Claudio</au><aucorp>SPaRo Group</aucorp><aucorp>SPaRo Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Implementation of a strategic preoperative surgical meeting to improve the level of care at a high-volume pancreatic center: a before–after analysis of 1000 consecutive cases</atitle><jtitle>Updates in Surgery</jtitle><stitle>Updates Surg</stitle><addtitle>Updates Surg</addtitle><date>2020-03-01</date><risdate>2020</risdate><volume>72</volume><issue>1</issue><spage>155</spage><epage>161</epage><pages>155-161</pages><issn>2038-131X</issn><eissn>2038-3312</eissn><abstract>The indication, planning, and risk analysis of a pancreatic surgical procedure have recently become increasingly complex. In December 2015, the “Pancreas Round” (PR) meeting was established at our institution to preoperatively review all scheduled cases with a specific focus on surgical indications and technical issues. The present study aims to determine the impact of the PR on the clinical practice in terms of avoiding unrequested laparotomies and anticipating intraoperative pitfalls. A “before–after” study was conducted by retrospectively comparing a pre-intervention period (9/2014–11/2015) to a prospectively assessed post-intervention one (12/2015–3/2017). Outcomes considered were explorative laparotomy (EL) occurrence and a “mismatch” between what was preoperatively expected by the PR and what was intraoperatively found. Of the 1057 patients included in the present study, 531 underwent surgery in the pre- and 526 in the post-intervention period, respectively. The EL rate was comparable between the two periods (15.4% vs. 12.2%, p  = 0.123), despite the significant increase of surgical explorations after neoadjuvant chemotherapy during the post-intervention period (27% vs. 18%, p  &lt; 0.001). The “mismatch” rate between preoperative planning and intraoperative findings was significantly reduced in the post-intervention period (12.2% vs. 8.4%, p  = 0.038) compared to the pre-PR period. In the setting of a high-volume center, a preoperative surgical meeting designed to review all cases scheduled for surgical exploration can enhance the level of care by addressing intraoperative pitfalls.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>32026398</pmid><doi>10.1007/s13304-020-00707-8</doi><tpages>7</tpages></addata></record>
fulltext fulltext
identifier ISSN: 2038-131X
ispartof Updates in Surgery, 2020-03, Vol.72 (1), p.155-161
issn 2038-131X
2038-3312
language eng
recordid cdi_proquest_miscellaneous_2352053441
source SpringerNature Journals
subjects Medical research
Medicine
Medicine & Public Health
Medicine, Experimental
Original Article
Risk assessment
Surgery
title Implementation of a strategic preoperative surgical meeting to improve the level of care at a high-volume pancreatic center: a before–after analysis of 1000 consecutive cases
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-23T16%3A20%3A55IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_proqu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Implementation%20of%20a%20strategic%20preoperative%20surgical%20meeting%20to%20improve%20the%20level%20of%20care%20at%20a%20high-volume%20pancreatic%20center:%20a%20before%E2%80%93after%20analysis%20of%201000%20consecutive%20cases&rft.jtitle=Updates%20in%20Surgery&rft.au=Surci,%20Niccol%C3%B2&rft.aucorp=SPaRo%20Group&rft.date=2020-03-01&rft.volume=72&rft.issue=1&rft.spage=155&rft.epage=161&rft.pages=155-161&rft.issn=2038-131X&rft.eissn=2038-3312&rft_id=info:doi/10.1007/s13304-020-00707-8&rft_dat=%3Cgale_proqu%3EA710618611%3C/gale_proqu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2352053441&rft_id=info:pmid/32026398&rft_galeid=A710618611&rfr_iscdi=true