Benchmarking to validate the implementation of a robotic colorectal cancer surgery program. Proposal for a new method...

Area of Science:

• Surgical Oncology
• Robotic Surgery
• Quality Improvement

Background:

• Benchmarking is crucial for assessing surgical quality but is limited in robotic colorectal cancer surgery (RCCS).
• Validating RCCS program outcomes against established standards is essential for quality assurance.

Purpose of the Study:

• To evaluate if a low-volume RCCS program meets existing benchmark standards.
• To propose a novel methodology for generating benchmarks in RCCS.

Main Methods:

• Retrospective observational study of 97 patients undergoing robot-assisted colorectal surgery (June 2019-May 2024).
• Analysis of outcomes for rectal cancer, colon cancer, and right hemicolectomy subgroups.
• Comparison of results against published benchmarks and newly generated references using a proposed method.

Main Results:

• Rectal cancer outcomes met established benchmarks for mortality, anastomotic leak, conversion, hospital stay, mesorectal integrity, margins, resection rates, lymph nodes, and operative time.
• Overall and severe morbidity were comparable to the 75th percentile, with a slightly higher reoperation rate.
• Right hemicolectomy outcomes were within benchmarks, except for operative time.

Conclusions:

• Benchmarking effectively validates RCCS programs, even in low-volume settings.
• The proposed method can generate valuable references in the absence of validated benchmarks.
• Further research on RCCS benchmarking is warranted.