Synoptic reporting of cytoreductive surgical procedures for patients with peritoneal malignancy based on the...

Cytoreductive surgery (CRS), for peritoneal malignancies (PM) is performed with the goal of achieving a CC-0 resection. However, the extent of peritonectomy and type of visceral resections (oncological versus non-oncological) performed during CRS vary among surgeons and lack standardization. The classification of peritonectomy procedures was revised by a consensus among some of the most experienced CRS surgeons in the world, defining the subdivisions and boundaries of each procedure. A format of documenting the extent of peritoneal resection was created which is an important research tool. To precisely report the extent and complexity of CRS, other aspects like the extent of exploration of the abdominal cavity and occult peritoneal spaces, the peritoneal disease extent and the visceral resections performed should be documented in a uniform manner. In the era of precision medicine, CRS needs to be standardized as much as possible. Thus, the working group for the Lyon consensus has created a form for synoptic reporting for CRS in an effort to further standardize CRS and facilitate future research. This form incorporates the surgical Peritoneal Cancer Index (PCI) including morphological appearance of PM, peritonectomy procedures and extent of peritoneal resection, visceral resections (oncological versus non-oncological), lymphadenectomy, extra-abdominal resections, abdominal wall resections, reconstruction procedures, and residual PCI. An online platform has been developed to generate structured operative reports incorporating all the details in this form (www.crs-report.com). Synoptic reporting will facilitate research and help define surgical strategies. It will help classify CRS according to its complexity clarifying formulation of recommendations for perioperative care.