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Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023
Evidence-based strategies to improve implementation of tumor isolation techniques in colorectal cancer surgery
Hailei Bian1, Qingqing Du2,3, Saishan Zhu1
1Department of Operating Room, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.
Objective:
This study aimed to develop evidence-based implementation strategies for colorectal cancer (CRC) surgical isolation techniques and evaluate current compliance through a baseline clinical audit, as part of a JBI evidence translation project.
Methods:
Following PRISMA and the PIPOST model, 8 studies were included and 10 best evidence items were extracted.
Results:
A baseline audit at a Shanghai Grade 3A hospital (n = 242 patients, 28 nurses, 13 surgeons) revealed compliance below 60% for 7 of 10 audit indicators (e.g., abdominal cavity flushing: 45.45%; intraoperative glove replacement: 45.87%), while two high-level evidence indicators achieved 100% compliance. Key barriers included insufficient training (65.70% compliance) and poor team communication. Facilitators included staff training willingness and adequate equipment.
Conclusion:
The study presents a multi-level strategy framework targeting system, practitioner, and patient factors to standardize practice and improve compliance with tumor isolation techniques. The effectiveness of these strategies in reducing iatrogenic metastasis requires future evaluation through post-intervention re-audit.
