Quality improvement in managing patients with non-muscle-invasive bladder cancer by introducing a surgical checklist for transurethral resection of bladder tumor.
<h4>Background</h4>The quality of transurethral resection of bladder tumor (TURBT) markedly varies among surgeons and may have a considerable impact on treatment outcomes. The importance of a surgical checklist for TURBT has been suggested in order to standardize the procedure and improv...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0276816 |
| _version_ | 1798044801396899840 |
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| author | Hiroshi Kikuchi Takahiro Osawa Takashige Abe Ryuji Matsumoto Satoru Maruyama Sachiyo Murai Nobuo Shinohara |
| author_facet | Hiroshi Kikuchi Takahiro Osawa Takashige Abe Ryuji Matsumoto Satoru Maruyama Sachiyo Murai Nobuo Shinohara |
| author_sort | Hiroshi Kikuchi |
| collection | DOAJ |
| description | <h4>Background</h4>The quality of transurethral resection of bladder tumor (TURBT) markedly varies among surgeons and may have a considerable impact on treatment outcomes. The importance of a surgical checklist for TURBT has been suggested in order to standardize the procedure and improve surgical and oncological outcomes. In the present study, we verified the usefulness of a checklist for managing patients with non-muscle-invasive bladder cancer (NMIBC).<h4>Methods</h4>This retrospective study included 201 NMIBC patients diagnosed with Ta, T1, or Tis between October 2011 and February 2021. After September 2016, TURBT was performed with a checklist. We analyzed the intravesical recurrence-free survival (RFS) rate and the presence or absence of the detrusor muscle in resected specimens before and after the introduction of the checklist. Survival rates were compared using the Log-rank test. A multivariate analysis with Cox proportional hazards modeling was performed to verify risk factors for intravesical recurrence.<h4>Results</h4>Ninety-nine patients who underwent TURBT with the checklist (checklist group) were compared with 102 patients who underwent TURBT without the checklist (non-checklist group). When the analysis was narrowed down to 9 critical items, we observed a mean number of 9 documented items per operative report (98.0% completion) after implementation of the checklist. Two-year intravesical RFS rates in the checklist and non-checklist groups were 76.7 and 69.5%, respectively (p = 0.1059). The Cox proportional multivariate analysis showed that the rate of intravesical recurrence was slightly lower in the checklist group (hazard ratio 0.7376, 95% CI 0.4064-1.3388, P = 0.3170).<h4>Conclusion</h4>The introduction of a checklist is recommended for the standardization of TURBT and increasing the quality of operative reporting, and it may also improve oncological outcomes. |
| first_indexed | 2024-04-11T23:10:10Z |
| format | Article |
| id | doaj.art-c4dd857f64274e0b819b3a001ed47071 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-11T23:10:10Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-c4dd857f64274e0b819b3a001ed470712022-12-22T03:57:53ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-011710e027681610.1371/journal.pone.0276816Quality improvement in managing patients with non-muscle-invasive bladder cancer by introducing a surgical checklist for transurethral resection of bladder tumor.Hiroshi KikuchiTakahiro OsawaTakashige AbeRyuji MatsumotoSatoru MaruyamaSachiyo MuraiNobuo Shinohara<h4>Background</h4>The quality of transurethral resection of bladder tumor (TURBT) markedly varies among surgeons and may have a considerable impact on treatment outcomes. The importance of a surgical checklist for TURBT has been suggested in order to standardize the procedure and improve surgical and oncological outcomes. In the present study, we verified the usefulness of a checklist for managing patients with non-muscle-invasive bladder cancer (NMIBC).<h4>Methods</h4>This retrospective study included 201 NMIBC patients diagnosed with Ta, T1, or Tis between October 2011 and February 2021. After September 2016, TURBT was performed with a checklist. We analyzed the intravesical recurrence-free survival (RFS) rate and the presence or absence of the detrusor muscle in resected specimens before and after the introduction of the checklist. Survival rates were compared using the Log-rank test. A multivariate analysis with Cox proportional hazards modeling was performed to verify risk factors for intravesical recurrence.<h4>Results</h4>Ninety-nine patients who underwent TURBT with the checklist (checklist group) were compared with 102 patients who underwent TURBT without the checklist (non-checklist group). When the analysis was narrowed down to 9 critical items, we observed a mean number of 9 documented items per operative report (98.0% completion) after implementation of the checklist. Two-year intravesical RFS rates in the checklist and non-checklist groups were 76.7 and 69.5%, respectively (p = 0.1059). The Cox proportional multivariate analysis showed that the rate of intravesical recurrence was slightly lower in the checklist group (hazard ratio 0.7376, 95% CI 0.4064-1.3388, P = 0.3170).<h4>Conclusion</h4>The introduction of a checklist is recommended for the standardization of TURBT and increasing the quality of operative reporting, and it may also improve oncological outcomes.https://doi.org/10.1371/journal.pone.0276816 |
| spellingShingle | Hiroshi Kikuchi Takahiro Osawa Takashige Abe Ryuji Matsumoto Satoru Maruyama Sachiyo Murai Nobuo Shinohara Quality improvement in managing patients with non-muscle-invasive bladder cancer by introducing a surgical checklist for transurethral resection of bladder tumor. PLoS ONE |
| title | Quality improvement in managing patients with non-muscle-invasive bladder cancer by introducing a surgical checklist for transurethral resection of bladder tumor. |
| title_full | Quality improvement in managing patients with non-muscle-invasive bladder cancer by introducing a surgical checklist for transurethral resection of bladder tumor. |
| title_fullStr | Quality improvement in managing patients with non-muscle-invasive bladder cancer by introducing a surgical checklist for transurethral resection of bladder tumor. |
| title_full_unstemmed | Quality improvement in managing patients with non-muscle-invasive bladder cancer by introducing a surgical checklist for transurethral resection of bladder tumor. |
| title_short | Quality improvement in managing patients with non-muscle-invasive bladder cancer by introducing a surgical checklist for transurethral resection of bladder tumor. |
| title_sort | quality improvement in managing patients with non muscle invasive bladder cancer by introducing a surgical checklist for transurethral resection of bladder tumor |
| url | https://doi.org/10.1371/journal.pone.0276816 |
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