Importance Despite ongoing advances in the field of colorectal surgery, the quality of surgical treatment is still variable. As an intrinsic part of surgical quality, the technical information regarding the surgical procedure is reflected only by the narrative operative report (NR), which has been found to be subjective and regularly omits important information.

Objective To investigate systematic video recording (SVR) as a potential improvement in quality and safety with regard to important information in colorectal cancer surgery.

Design, Setting, and Participants The Imaging for Quality Control Trial was a prospective, observational cohort study conducted between January 12, 2016, and October 30, 2017, at 3 centers in the Netherlands. The study group consisted of 113 patients 18 years or older undergoing elective laparoscopic surgery for colorectal cancer. These patients were case matched and compared with cases from a historical cohort that received only an NR.

Interventions Among study cases, participating surgeons were requested to systematically capture predefined key steps of the surgical procedure intraoperatively on video in short clips.

Main Outcomes and Measures The SVRs and NRs were analyzed for adequacy with respect to the availability of important information regarding the predefined key steps. Adequacy of the reported information was defined as the proportion of key steps with available and sufficient information in the report. Adequacy of the SVR and NR was compared between the study and control groups, with the SVR alone and as an adjunct to the NR in the study group vs NR alone in the control group.

Results Of the 113 study patients, 69 women (61.1%) were included; mean (SD) age was 66.3 (9.8) years. In the control group, a mean (SD) of 52.5% (18.3%) of 631 steps were adequately described in the NR. In the study group, the adequacy of both the SVR (78.5% [16.5%], P < .001) and a combination of the SVR with NR (85.1% [14.6%], P < .001) was significantly superior to NR alone. The only significant difference between the study and historical control groups regarding postoperative and pathologic outcomes was a shorter postoperative mean (SD) length of stay in favor of the study group (8.0 [7.7] vs 8.6 [6.8] days; P = .03).

Conclusions and Relevance Use of SVR in laparoscopic colorectal cancer surgery as an adjunct to the NR might be superior in documenting important steps of the operation compared with NR alone, adding to the overall availability of necessary intraoperative information and contributing to quality control and objectivity.

重要性 尽管在结直肠外科领域不断取得进步，但外科治疗的质量仍然参差不齐。作为手术质量的内在部分，有关手术程序的技术信息仅由叙述性手术报告（NR）反映出来，该报告被认为是主观的，并且经常忽略重要信息。

目的 研究系统视频记录（SVR），对大肠癌手术中的重要信息在质量和安全性方面的潜在改善。

设计，设置和参与者 “质量控制影像学试验”是一项前瞻性观察性队列研究，于2016年1月12日至2017年10月30日在荷兰的3个中心进行。该研究小组由113例18岁以上的大肠癌接受选择性腹腔镜手术的患者组成。将这些患者进行病例匹配，并与仅接受NR的历史队列病例进行比较。

干预措施 在研究案例中，要求参与的外科医师在短片视频中系统地捕获术中手术过程中预定义的关键步骤。

主要结果和措施 对SVR和NR进行足够的分析，以获取有关预定义关键步骤的重要信息。报告信息的充分性定义为报告中具有可用信息和足够信息的关键步骤所占的比例。在研究组和对照组之间比较了SVR和NR的充分性，单独使用SVR并作为研究组NR的辅助与对照组中的单独NR进行了比较。

结果 113名研究患者中，有69名女性（占61.1％）被纳入研究。平均（SD）年龄为66.3（9.8）岁。在对照组中，NR中充分描述了631步的52.5％（18.3％）的平均值（SD）。在研究组中，SVR（78.5％[16.5％]，P  <.001）和SVR与NR联合使用的适当性（85.1％[14.6％]，P  <.001）均显着优于NR。独自的。研究组和历史对照组之间在术后和病理学结局方面的唯一显着差异是有利于研究组的术后平均住院天数（SD）较短（8.0 [7.7] vs 8.6 [6.8]天；P  = .03） 。

结论和相关性 与单独使用NR相比，SVR在腹腔镜结直肠癌手术中作为NR的辅助手段可能在记录重要的手术步骤方面具有优势，从而增加了必要的术中信息的整体可用性并有助于质量控制和客观性。