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Observatory of the Quality of Surgical Procedures for Digestive Cancers in Morocco (Obchir): Protocol of a Prospective, Multicentric Cohort Study (Pilot study)

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Amine Souadka, Mohammed Anass Majbar, Khalid El Himdi, Ismail Kassou, Hind Mrabti, Tijani El Harroudi, Mohammed Ahallat, Abdelkader Belkouchi, Raouf Mohsine, Abdelmalek Hrora, Amine Benkabbou

JOURNAL OF MEDICAL AND SURGICAL RESEARCH – Vol. VII, n 1, June, 2020; Pages: 748-754

Abstract:

Background: Surgical audit experiments have shown a positive, rapid and cost-effective impact on complication rates, recurrence rates, and overall survival even in the absence of interventional measures in digestive cancers. This study audit the quality of surgical procedures for digestive cancers.

Methods: This is a multicentric prospective non-comparative observational study performed in 4 surgical departments in 2 university centers. Eligible patients are adults scheduled for elective surgery for a proven or suspected digestive cancer, in a curative or palliative intent; or included no later than 72 hours after surgery in case of an emergent procedure. The Cancer should be proven or suspected in the following digestive tract: colon, appendix, anus, rectum, esophagus, stomach, esogastric junction, bile ducts, ampulla of Vater, pancreas, duodenum, small intestine and liver. Patients are excluded in case of 1) surgical intervention indicated for: a condition that is not a digestive tract cancer; 2) proven or suspected cancer of non-digestive location 3) a proven or suspected cancer of peritoneal localization. 4) surgical intervention indicated for a progressive disease or a local recurrence proven or suspected of a digestive localization cancer having already been resected (with the exception of situations of iterative liver resection for liver metastasis hepatic and recovery of the tumor bed after the discovery of vesicular cancer on cholecystectomy specimen); 5) intervention is for diagnostic purposes without any curative or palliative intention

A total of 1500 patients is expected. The primary objectives of this study are to assess both 90 days of post-operative outcomes and three years oncological outcomes for patient operated for each included digestive cancer. Secondary objectives arre 1)to analyze treatment decisions made within multidisciplinary team meeting/tumour board for every localization and the completion of preoperative workup staging according to local guidelines and 2) to determine the impact of reporting anonymous trimestrial feedback to surgeons on improving their surgical performance and outcomes 3) To assess quality of life in patient operated for colorectal cancer in curative intent.

Discussion: This is the first multicentric north african registry assessing the quality of surgical procedures for digestive tract cancer and analyzing the impact of reporting sequential anonymous feedback to the surgeon on quality improvement.

Keywords: Qualtiy, Rectal Neoplasms, Digestive cancer, obsergatory, Multicentric cohort study, Surgical procedures

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