A computer synoptic operative report versus a report dictated by a surgeon in advanced ovarian cancer.

OBJECTIVE: To evaluate the role of a computer synoptic operative report in enhancing the quality and completeness of surgical reporting for advanced ovarian cancer surgeries. METHODS: The study was conducted at a tertiary cancer center between January 2016 and September 2021, and the computer synoptic operative report was implemented in May 2019. The study compared two cohorts: the first consisted of the 'before computer synoptic operative report (P1)' period, during which the operative reports were dictated freely by the surgeons, and the second consisted of the 'after computer synoptic operative report (P2)' period, during which all surgeons used the computer synoptic operative report. RESULTS: The study analyzed 227 operative reports, with 104 during period 1 (P1) and 123 during period 2 (P2). In the P1 group, more than half of the patients (54 out of 104, 52%) underwent interval surgery after completing six cycles of chemotherapy; In contrast, in the P2 group, all interval debulking surgeries were performed after fewer than six chemotherapy cycles (p<0.001). Although interval debulking surgery after fewer than six chemotherapy cycles was more frequent in P2, the rate of primary debulking surgery was similar between the groups. The median intra-operative peritoneal carcinomatosis index was higher in P2 (2 in P1 vs 4 in P2, p<0.001), and mean blood loss was higher in P1 (308 mL vs 151 mL, p<0.001). The rate of complete cytoreduction was similar between P1 and P2 (97% vs 87%, respectively, p=0.6). The median length of hospital stay was 12 days in the P1 group and 16 days in the P2 group (p=0.5). Compliance with all eight significant items was higher in the P2 group, with all items present in 66% of the operative reports in the P2 group compared with none of the reports in the P1 group. Compliance for the following items was: International Federation of Obstetrics and Gynecology stage (24% vs 100%), histology (76% vs 97%), CA125 (63% vs 89%), type of surgery (38% vs 100%), peritoneal carcinomatosis index (21% vs 100%), complete cytoreduction score 36% vs 99%), Aletti score (0% vs 89%), and blood loss (32% vs 98%) for P1 and P2; respectively. CONCLUSION: The use of the computer synoptic operative report improved the completeness and quality of the surgical information documented in advanced ovarian cancer surgeries.

Midline rectovaginal fascial plication: Anatomical and functional outcomes at one year.

OBJECTIVES: To evaluate anatomical and functional results at one year of midline rectovaginal fascial plication (MFP) for rectocele. MATERIAL AND METHODS: Single-center observational study performed in a gynecologic-obstetrics department of a university hospital. Inclusion criteria were patients with isolated or associated rectocele treated by MFP. The success rate defined by a Bp point < 0 cm, improvement of symptoms, and satisfaction were evaluated at one year. Quality of life questionnaires were distributed pre- and postoperatively at one year. RESULTS: 34/46 (74%) patients were interviewed pre and postoperatively including a POPQ evaluation in only 30 patients. Anatomical success rate was 28/30 (93%) (p < 0.0001). There was an improvement in the sensation of vaginal bulge with 22/34 patients (65%) no longer having this symptom (p < 0.0001) and only one patient (1/34, 3%) underwent surgery for recurrence of the rectocele. 24/34 patients (71%) were satisfied with their surgery at one year. CONCLUSION: Anatomical and functional results of MFP for rectocele are encouraging and must be confirmed on a longer follow up.