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Development of The American Society of Colon and Rectal Surgeons’ Rectal Cancer Surgery Checklist

Glasgow, Sean C. M.D.1; Morris, Arden M. M.D., M.P.H.2; Baxter, Nancy N. M.D., Ph.D.3; Fleshman, James W. M.D.4; Alavi, Karim S. M.D.5; Luchtefeld, Martin A. M.D.6; Monson, John R. T. M.D.7; Chang, George J. M.D., M.S.8; Temple, Larissa K. M.D., M.Sc.9

Diseases of the Colon & Rectum: July 2016 - Volume 59 - Issue 7 - p 601–606
doi: 10.1097/DCR.0000000000000606
Original Contributions: Colorectal/Anal Neoplasia

BACKGROUND: There is excellent evidence that surgical safety checklists contribute to decreased morbidity and mortality.

OBJECTIVE: The purpose of this study was to develop a surgical checklist composed of the key phases of care for patients with rectal cancer.

DESIGN: A consensus-oriented decision-making model involving iterative input from subject matter experts under the auspices of The American Society of Colon and Rectal Surgeons was designed.

SETTINGS: The study was conducted through meetings and discussion to consensus.

PATIENTS: Patient data were extracted from an initial literature review.

MAIN OUTCOME MEASURES: The checklist was measured by its ability to improve care in complex rectal surgery cases by reducing the possibility of omission through the division of treatment into 3 distinct phases.

RESULTS: The process generated a 25-item checklist covering the spectrum of care for patients with rectal cancer who were undergoing surgery.

LIMITATIONS: The study was limited by its lack of prospective validation.

CONCLUSIONS: The American Society of Colon and Rectal Surgeons rectal cancer surgery checklist is composed of the essential elements of preoperative, intraoperative, and postoperative care that must be addressed during the surgical treatment of patients with rectal cancer.

1 Department of Surgery, Washington University School of Medicine and US Air Force C-STARS, St. Louis, Missouri

2 Department of Surgery, University of Michigan, Ann Arbor, Michigan

3 Department of Surgery, University of Toronto, Toronto, Ontario, Canada

4 Department of Surgery, Baylor University Medical Center, Dallas, Texas

5 Department of Surgery, University of Massachusetts Medical School, Worcester, Massachusetts

6 Ferguson Clinic, Grand Rapids, Michigan

7 Department of Surgery, University of Rochester Medical Center, Rochester, New York

8 Departments of Surgical Oncology and Health Services Research, University of Texas, MD Anderson Cancer Center, Houston, Texas

9 Department of Surgery, Memorial Sloan Kettering Medical Center, New York, New York

Funding/Support: This study was funded in part by the Memorial Sloan Kettering Cancer Center core grant P30 CA008748 (to L.K.T.).

Financial Disclosure: None reported.

Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, Vancouver, British Columbia, Canada, May 14 to 18, 2011.

Correspondence: Larissa K. Temple, M.D., M.Sc., SR203, 1233 York Ave, Memorial Sloan Kettering Cancer Center, New York, NY 10065. E-mail:

© 2016 The American Society of Colon and Rectal Surgeons