[Coproductive teamwork in surgical cancer treatment]

With regard to surgical treatment of cancer, there is a strong demand for safe treatment with few errors: treatment must be based on transparency, understandability, and rationality. There is also demand for treatment which is quick, efficient and not wasteful. Rather than maintaining our current pyramidal system which has doctors standing as authorities at the top, there is a need for a flat, non-authoritarian system at every level and section of the hospital. As we change methodology, electronic medical records and clinical pathways will be important tools. Among the surgical department's treatment team in our hospital, there are many branches at work on peri-operative management aside from operations; There are teams for infection control (ICT), nutrition support (NST), decubitus and stoma management, rehabilitaion, and chemotherapy, and team cooperation after discharge from hospital. In addition, the collaborative and coproductive team focusing on pain releif and palliative care in terminal phase (PCT) is important. Having introduced each of the parts of team treatment within the setting of the surgical department, the need now for strong leadership from young and brightful surgeons is also emphasized.