Surgical Experience and Checklist Adherence Impacts Bladder Cancer Surgery Outcomes

What is it about?

The study aimed to evaluate the association of perioperative surgical checklist with transurethral resection of bladder tumour (TURBT) accuracy and oncological outcomes in non-muscle-invasive bladder cancer. The study found that residents were more likely to have detrusor muscle in the TURBT specimen than expert consultants, while no differences in DM presence were seen between young vs expert consultants. The median checklist completion rate was higher for both residents and young consultants when compared to experts' counterparts. The study concluded that both bladder cancer survival and management rely on accurate tumour staging at the primary diagnosis, which is directly correlated to the quality of the initial TURBT.

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Why is it important?

This research is important because it investigates the impact of perioperative surgical checklists on the accuracy and oncological outcomes of transurethral resection of bladder tumor (TURBT) in non-muscle-invasive bladder cancer. By analyzing a large, prospective collaborative database of patients treated with TURBT between 2012 and 2017, the study provides insights into how surgical experience affects the quality of the procedure and outcomes. Key Takeaways: 1. Surgical experience was stratified into three groups: resident vs young vs expert consultants. 2. Residents were more likely to have detrusor muscle (DM) in the TURBT specimen than expert consultants. 3. No differences in DM presence were seen between young vs expert consultants. 4. The median checklist completion rate was higher for both residents and young consultants when compared to experts' counterparts. 5. At the final pathological report, DM was present in 50.6%, 54.4%, and 62.9% of specimens provided by experts, young consultants, and residents, respectively. 6. Residents were more likely to include DM than expert consultants, while no differences were observed between young vs expert consultants. 7. The addition of each single SC item was found to increase the probability of DM sampling by 18%. 8. The study underlines the importance of standardizing the resecting technique by implementing perioperative reporting through a surgical checklist, which may adjust for expertise imbalances and result in even better perioperative outcomes regardless of the learning curve background.