Achieving high quality standards in laparoscopic colon resection for cancer: A Delphi consensus-based position paper

MISiCOL Task Force

Research output: Contribution to journalReview article

Abstract

AIM: To investigate the rate of laparoscopic colectomies for colon cancer using registries and population-based studies. To provide a position paper on mini-invasive (MIS) colon cancer surgery based on the opinion of experts leader in this field.

METHODS: A systematic review of the literature was conducted using PRISMA guidelines for the rate of laparoscopy in colon cancer. Moreover, Delphi methodology was used to reach consensus among 35 international experts in four study rounds. Consensus was defined as an agreement ≥75.0%. Domains of interest included nosology, essential technical/oncological requirements, outcomes and MIS training.

RESULTS: Forty-four studies from 42 articles were reviewed. Although it is still sub-optimal, the rate of MIS for colon cancer increased over the years and it is currently >50% in Korea, Netherlands, UK and Australia. The remaining European countries are un-investigated and presented lower rates with highest variations, ranging 7-35%. Using Delphi methodology, a laparoscopic colectomy was defined as a "colon resection performed using key-hole surgery independently from the type of anastomosis". The panel defined also the oncological requirements recognized essential for the procedure and agreed that when performed by experienced surgeons, it should be marked as best practice in guidelines, given the principles of oncologic surgery be respected (R0 procedure, vessel ligation and mesocolon integrity).

CONCLUSION: The rate of MIS colectomies for cancer in Europe should be further investigated. A panel of leaders in this field defined laparoscopic colectomy as a best practice procedure when performed by an experienced surgeon respecting the standards of surgical oncology.

Original languageEnglish
Pages (from-to)469-483
Number of pages15
JournalEuropean Journal of Surgical Oncology
Volume44
Issue number4
DOIs
Publication statusPublished - Apr 2018

Fingerprint

Colectomy
Colonic Neoplasms
Practice Guidelines
Mesocolon
Expert Testimony
Korea
Netherlands
Laparoscopy
Ligation
Registries
Colon
Guidelines
Population
Neoplasms
Surgeons

Keywords

  • Colectomy/standards
  • Colonic Neoplasms/surgery
  • Delphi Technique
  • Humans
  • Laparoscopy/standards
  • Quality Assurance, Health Care

Cite this

Achieving high quality standards in laparoscopic colon resection for cancer : A Delphi consensus-based position paper. / MISiCOL Task Force.

In: European Journal of Surgical Oncology, Vol. 44, No. 4, 04.2018, p. 469-483.

Research output: Contribution to journalReview article

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title = "Achieving high quality standards in laparoscopic colon resection for cancer: A Delphi consensus-based position paper",
abstract = "AIM: To investigate the rate of laparoscopic colectomies for colon cancer using registries and population-based studies. To provide a position paper on mini-invasive (MIS) colon cancer surgery based on the opinion of experts leader in this field.METHODS: A systematic review of the literature was conducted using PRISMA guidelines for the rate of laparoscopy in colon cancer. Moreover, Delphi methodology was used to reach consensus among 35 international experts in four study rounds. Consensus was defined as an agreement ≥75.0{\%}. Domains of interest included nosology, essential technical/oncological requirements, outcomes and MIS training.RESULTS: Forty-four studies from 42 articles were reviewed. Although it is still sub-optimal, the rate of MIS for colon cancer increased over the years and it is currently >50{\%} in Korea, Netherlands, UK and Australia. The remaining European countries are un-investigated and presented lower rates with highest variations, ranging 7-35{\%}. Using Delphi methodology, a laparoscopic colectomy was defined as a {"}colon resection performed using key-hole surgery independently from the type of anastomosis{"}. The panel defined also the oncological requirements recognized essential for the procedure and agreed that when performed by experienced surgeons, it should be marked as best practice in guidelines, given the principles of oncologic surgery be respected (R0 procedure, vessel ligation and mesocolon integrity).CONCLUSION: The rate of MIS colectomies for cancer in Europe should be further investigated. A panel of leaders in this field defined laparoscopic colectomy as a best practice procedure when performed by an experienced surgeon respecting the standards of surgical oncology.",
keywords = "Colectomy/standards, Colonic Neoplasms/surgery, Delphi Technique, Humans, Laparoscopy/standards, Quality Assurance, Health Care",
author = "{MISiCOL Task Force} and Laura Lorenzon and Alberto Biondi and Thomas Carus and Adam Dziki and Eloy Espin and Nuno Figueiredo and Ruiz, {Marcos Gomez} and Tamas Mersich and Isacco Montroni and Tanis, {Pieter J} and Benz, {Stefan Rolf} and Bianchi, {Paolo Pietro} and Matthias Biebl and Ivo Broeders and {De Luca}, Raffaele and Paolo Delrio and Mathieu D'Hondt and Alois F{\"u}rst and Jan Grosek and {Guimaraes Videira}, {Jose Flavio} and Friedrich Herbst and David Jayne and Gy{\"o}rgy L{\'a}z{\'a}r and Danilo Miskovic and Andrea Muratore and {Helmer Sjo}, Ole and Tom Scheinin and Ales Tomazic and Andreas T{\"u}rler and {Van de Velde}, Cornelius and Wexner, {Steven D} and Christoph Wullstein and Wojciech Zegarski and Domenico D'Ugo",
note = "Copyright {\circledC} 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.",
year = "2018",
month = "4",
doi = "10.1016/j.ejso.2018.01.091",
language = "English",
volume = "44",
pages = "469--483",
journal = "European Journal of Surgical Oncology",
issn = "0748-7983",
publisher = "W.B. Saunders Ltd",
number = "4",

}

TY - JOUR

T1 - Achieving high quality standards in laparoscopic colon resection for cancer

T2 - A Delphi consensus-based position paper

AU - MISiCOL Task Force

AU - Lorenzon, Laura

AU - Biondi, Alberto

AU - Carus, Thomas

AU - Dziki, Adam

AU - Espin, Eloy

AU - Figueiredo, Nuno

AU - Ruiz, Marcos Gomez

AU - Mersich, Tamas

AU - Montroni, Isacco

AU - Tanis, Pieter J

AU - Benz, Stefan Rolf

AU - Bianchi, Paolo Pietro

AU - Biebl, Matthias

AU - Broeders, Ivo

AU - De Luca, Raffaele

AU - Delrio, Paolo

AU - D'Hondt, Mathieu

AU - Fürst, Alois

AU - Grosek, Jan

AU - Guimaraes Videira, Jose Flavio

AU - Herbst, Friedrich

AU - Jayne, David

AU - Lázár, György

AU - Miskovic, Danilo

AU - Muratore, Andrea

AU - Helmer Sjo, Ole

AU - Scheinin, Tom

AU - Tomazic, Ales

AU - Türler, Andreas

AU - Van de Velde, Cornelius

AU - Wexner, Steven D

AU - Wullstein, Christoph

AU - Zegarski, Wojciech

AU - D'Ugo, Domenico

N1 - Copyright © 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

PY - 2018/4

Y1 - 2018/4

N2 - AIM: To investigate the rate of laparoscopic colectomies for colon cancer using registries and population-based studies. To provide a position paper on mini-invasive (MIS) colon cancer surgery based on the opinion of experts leader in this field.METHODS: A systematic review of the literature was conducted using PRISMA guidelines for the rate of laparoscopy in colon cancer. Moreover, Delphi methodology was used to reach consensus among 35 international experts in four study rounds. Consensus was defined as an agreement ≥75.0%. Domains of interest included nosology, essential technical/oncological requirements, outcomes and MIS training.RESULTS: Forty-four studies from 42 articles were reviewed. Although it is still sub-optimal, the rate of MIS for colon cancer increased over the years and it is currently >50% in Korea, Netherlands, UK and Australia. The remaining European countries are un-investigated and presented lower rates with highest variations, ranging 7-35%. Using Delphi methodology, a laparoscopic colectomy was defined as a "colon resection performed using key-hole surgery independently from the type of anastomosis". The panel defined also the oncological requirements recognized essential for the procedure and agreed that when performed by experienced surgeons, it should be marked as best practice in guidelines, given the principles of oncologic surgery be respected (R0 procedure, vessel ligation and mesocolon integrity).CONCLUSION: The rate of MIS colectomies for cancer in Europe should be further investigated. A panel of leaders in this field defined laparoscopic colectomy as a best practice procedure when performed by an experienced surgeon respecting the standards of surgical oncology.

AB - AIM: To investigate the rate of laparoscopic colectomies for colon cancer using registries and population-based studies. To provide a position paper on mini-invasive (MIS) colon cancer surgery based on the opinion of experts leader in this field.METHODS: A systematic review of the literature was conducted using PRISMA guidelines for the rate of laparoscopy in colon cancer. Moreover, Delphi methodology was used to reach consensus among 35 international experts in four study rounds. Consensus was defined as an agreement ≥75.0%. Domains of interest included nosology, essential technical/oncological requirements, outcomes and MIS training.RESULTS: Forty-four studies from 42 articles were reviewed. Although it is still sub-optimal, the rate of MIS for colon cancer increased over the years and it is currently >50% in Korea, Netherlands, UK and Australia. The remaining European countries are un-investigated and presented lower rates with highest variations, ranging 7-35%. Using Delphi methodology, a laparoscopic colectomy was defined as a "colon resection performed using key-hole surgery independently from the type of anastomosis". The panel defined also the oncological requirements recognized essential for the procedure and agreed that when performed by experienced surgeons, it should be marked as best practice in guidelines, given the principles of oncologic surgery be respected (R0 procedure, vessel ligation and mesocolon integrity).CONCLUSION: The rate of MIS colectomies for cancer in Europe should be further investigated. A panel of leaders in this field defined laparoscopic colectomy as a best practice procedure when performed by an experienced surgeon respecting the standards of surgical oncology.

KW - Colectomy/standards

KW - Colonic Neoplasms/surgery

KW - Delphi Technique

KW - Humans

KW - Laparoscopy/standards

KW - Quality Assurance, Health Care

U2 - 10.1016/j.ejso.2018.01.091

DO - 10.1016/j.ejso.2018.01.091

M3 - Review article

C2 - 29422252

VL - 44

SP - 469

EP - 483

JO - European Journal of Surgical Oncology

JF - European Journal of Surgical Oncology

SN - 0748-7983

IS - 4

ER -