Learning Curve, Training Program, and Monitorization of Surgical Performance of Peritoneal Surface Malignancies Centers

Shigeki Kusamura; Santiago González-Moreno; Eran Nizri; Dario Baratti; Stefano Guadagni; Marcello Guaglio; Luigi Battaglia; Marcello Deraco

doi:10.1016/j.soc.2018.02.009

Learning Curve, Training Program, and Monitorization of Surgical Performance of Peritoneal Surface Malignancies Centers

Surg Oncol Clin N Am. 2018 Jul;27(3):507-517. doi: 10.1016/j.soc.2018.02.009.

Authors

Shigeki Kusamura¹, Santiago González-Moreno², Eran Nizri³, Dario Baratti¹, Stefano Guadagni⁴, Marcello Guaglio¹, Luigi Battaglia⁵, Marcello Deraco⁶

Affiliations

¹ Peritoneal Surface Malignancies unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, Milano, Milan cap 20133, Italy.
² Surgical Oncology, MD Anderson Cancer Center, Calle Arturo Soria, n°270, Madrid, Spain.
³ Department of General Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Weizmann Street 6, Tel Aviv, Israel.
⁴ Department of Biotechnological and Applied Clinical Sciences, Università degli Studi dell'Aquila, Via Giovanni di Vincenzo, 16/B, L'Aquila, Italy.
⁵ Colorectal Cancer unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, Milano, MI, cap 20133, Italy.
⁶ Peritoneal Surface Malignancies unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, Milano, Milan cap 20133, Italy. Electronic address: marcello.deraco@istitutotumori.mi.it.

PMID: 29935686
DOI: 10.1016/j.soc.2018.02.009

Abstract

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy is a complex procedure with high cost and significant morbidity and mortality. The associated learning curve is steep and could reliably be evaluated using specific statistics. Risk-adjusted sequential probability ratio test is an effective and robust method to monitor surgical performance in the learning and audit phase of a peritoneal surface malignancies center development. The most critical factor associated with surgical performance is mentoring of the trainee by an expert. A well-structured tutor-based training program has been implemented in Europe. This initiative will improve the standardization of the combined procedure and improve quality of services across the continent.

Keywords: Cytoreductive surgery; HIPEC; Learning curve; Surgical performance; Surgical training.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Cytoreduction Surgical Procedures / methods*
Education*
Humans
Learning Curve*
Monitoring, Physiologic*
Patient Outcome Assessment
Peritoneal Neoplasms / surgery*