Minimally Invasive Surgery for Colorectal Cancer: Benchmarking Uptake for a Regional Improvement Programme

IF 4.3 3区材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC

ACS Applied Electronic Materials Pub Date : 2024-06-18 DOI:10.1016/j.clcc.2024.05.013

John C. Taylor, Dermot Burke, Lene H. Iversen, Rebecca J. Birch, Paul J. Finan, Mark M. Iles, Philip Quirke, Eva J.A. Morris, YCR BCIP Study Group

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引用次数: 0

Abstract

The uptake of minimally invasive surgery (MIS) for patients with colorectal cancer has progressed at differing rates, both across countries, and within countries. This study aimed to investigate uptake for a regional colorectal cancer improvement programme in England. We calculated the proportion of patients receiving elective laparoscopic and robot-assisted surgery amongst those diagnosed with colorectal cancer over 3 time periods (2007-2011, 2012-2016 and 2017-2021) in hospitals participating in the Yorkshire Cancer Research Bowel Cancer Improvement Programme (YCR BCIP). These were benchmarked against national rates. Regression analysis and funnel plots were used to develop a data driven approach for analysing trends in the use of MIS at hospitals in the programme. In England, resections performed by MIS increased from 34.9% to 72.9% for colon cancer and from 28.8% to 72.5% for rectal cancer. Robot-assisted surgery increased from 0.1% to 2.7% for colon cancer and from 0.2% to 7.9% for rectal cancer. Wide variation in the uptake of MIS was observed at a hospital level. Detailed analysis of the YCR BCIP region identified a decreasing number of surgical departments, since the start of the programme, as potential outliers for MIS when compared to the English national average. Wide variation in use of MIS for colorectal cancer exists within the English National Health Service and a data-driven approach can help identify outlying hospitals. Addressing some of the challenges behind the uptake of MIS, such as ensuring adequate provision of surgical training and equipment, could help increase its use.

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结直肠癌微创手术：以地区改进计划的接受率为基准

在不同国家和国家内部，结直肠癌患者接受微创手术（MIS）的进度各不相同。本研究旨在调查英格兰地区结直肠癌改善计划的接受率。我们计算了参与约克郡癌症研究肠癌改善计划（YCR BCIP）的医院在三个时间段（2007-2011 年、2012-2016 年和 2017-2021 年）内确诊为结直肠癌的患者中接受选择性腹腔镜手术和机器人辅助手术的比例。这些数据以全国比率为基准。利用回归分析和漏斗图开发出一种数据驱动型方法，用于分析参与计划的医院使用 MIS 的趋势。在英格兰，结肠癌的 MIS 切除率从 34.9% 增加到 72.9%，直肠癌的 MIS 切除率从 28.8% 增加到 72.5%。结肠癌的机器人辅助手术从0.1%增加到2.7%，直肠癌的机器人辅助手术从0.2%增加到7.9%。在医院层面，MIS的使用率差异很大。对YCR BCIP地区进行的详细分析发现，与英国全国平均水平相比，自该计划启动以来，作为MIS潜在异常值的外科部门数量不断减少。在英国国家医疗服务机构中，结直肠癌 MIS 的使用情况存在很大差异，而数据驱动方法可以帮助确定离群医院。解决 MIS 使用率背后的一些挑战，如确保提供充足的手术培训和设备，将有助于提高其使用率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ACS Applied Electronic Materials Multiple-

CiteScore

7.20

自引率

4.30%

发文量

567