Article ID Journal Published Year Pages File Type
6250419 The American Journal of Surgery 2016 7 Pages PDF
Abstract

•Nearly all variables showed improvements almost immediately after initiation of MDT conferences, and showed continued improvement after 1 year.•Several variables have not reached a level that we find acceptable.•This emphasizes that initiation of MDT conferences do not solve every problem overnight, but instead lead to continued improvements over time.

BackgroundWe hypothesized that mandatory multidisciplinary team (MDT) participation improves process evaluation, outcomes, and technical aspects of surgery for rectal cancer in a stable practice of colorectal surgery.MethodsA retrospective review of MDT data was conducted of all patients with colorectal cancer since 2010. Demographic, clinical stage, process evaluation, quality of surgery, and outcome data were collected. Total mesorectal excision and MDT required participation started 2013.ResultsOne hundred thirty patients were included in this study: 47 patients in 2014; 41 patients in 2013; and 42 patients pre-MDT. Improvements were seen in 12 of the 14 preoperative process variables, 6 significantly. Improvement in the completeness of total mesorectal excision (0% to 76%) was significant. Local recurrence occurred in 10% of the pre-MDT group, and follow-up is ongoing in the MDT groups.ConclusionsMDT participation improves care of patients with rectal cancer. Preoperative clinical staging, multimodality treatment, pathologic staging, and technical aspects of surgery have improved.

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