The role of the multidisciplinary team in the management of deep infiltrating endometriosis

Ugwumadu, Lilian; Chakrabarti, Rima; Williams-Brown, Elaine; Rendle, John; Swift, Ian; John, Biku Joseph; Allen-Coward, Heather; Ofuasia, Emmanuel

doi:10.1186/s10397-017-1018-0

Cited by 30 publications

(20 citation statements)

References 29 publications

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“…15 With respect to MDT meetings running effectively, participants agreed that teamwork and respect was important as it would positively affect patient outcome and help provide a practical approach in delivering quality patient care. 16 Similar studies 12,17 have previously shown that poor interpersonal relationships and absence of teamwork were huge barriers to a successful MDT meeting, placing patient safety at risk and generating situations rife for medical errors. 18 As for key barriers to MDT meetings, it was agreed upon that lack of patient information was an important barrier because it served to inhibit decision making or provide patients with clinically inappropriate decisions.…”

Section: Discussionmentioning

confidence: 89%

The Evolving Role of National Tumor Board – Attitudes of Professionals Towards Multidisciplinary Team Meetings

2020

J Bah Med Soc

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Background and Objectives: Multidisciplinary team (MDT) meetings are an essential part of cancer management. While the importance of such meetings is generally acknowledged, the recent launch of Bahrain Oncology Centre and National Tumor Board provides an opportunity to assess the attitudes of its participants to the concept and its introduction to Bahrain. Methods: This study was conducted at Bahrain Oncology Center on 96 attendees that were encouraged to complete a questionnaire that asked 14 questions including three main questions, (a) Do you think that the MDT-Tumor Board is beneficial? (b) Are you satisfied with the structure and function of the MDT? (c) What are your perceptions on how it may be improved? Quantitative data was produced by using Likert 5-points scale to measure participants' agreement or non-agreement with different statements. Results: A total of 60 forms were completed and returned. Of these, 49 (81%) of participants strongly agreed that MDT meetings were beneficial to patient management. In addition, general satisfaction levels with MDT meetings according to Likert 5-points scale calculated from 14 MDT related questions showed that 36/60 participants were very satisfied (1), 22/60 participants were moderately satisfied (2), one participant was neutral (3), while one participant was moderately unsatisfied (4). Conclusion: This study confirmed that the majority of participants viewed MDT meetings as being beneficial to patient care. However, lack of patient information was considered a barrier to overall effectiveness, and 20% of the participants suggested that specialty specific meetings could improve the overall efficiency.

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Section: Discussionmentioning

confidence: 89%

The Evolving Role of National Tumor Board – Attitudes of Professionals Towards Multidisciplinary Team Meetings

2020

J Bah Med Soc

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“…The multidisciplinary team approach is considered as one of the essential practice in the management of chronic conditions. According to a study conducted by Ugwumadu et al [22], MDT is well established in the provision of clinical care in most critical care institutions. More importantly, in recent days there has been a drive to have MDT in the management of women experiencing severe endometriosis and who need complex surgery.…”

Section: Discussionmentioning

confidence: 99%

“…More importantly, in recent days there has been a drive to have MDT in the management of women experiencing severe endometriosis and who need complex surgery. In fact, the European Society for Human Reproduction and Embryology (ESHRE) and the British Society for Gynaecology Endoscopy (BSGE) have advocated for the implementation of the practice [22]. Further, both ESHRE and BSGE argue that the adoption of the multidisciplinary approach will lead to better results in patient care.…”

Section: Discussionmentioning

confidence: 99%

Multidisciplinary Team Approach for the Management of Severe Deeply Infiltrating Endometriosis

Zawwar¹,

Zehra²,

Neill³

et al. 2017

J Surg Anesth

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Introduction:Colorectal endometriosis results in alterations of bowel habit and rectal bleeding (rarely). Evaluation of the disease process and subsequent surgical planning is via a multidisciplinary team approach.Aim:The aim of our study is to analyze the gynecological endometriosis work load to assess colorectal involvement acquired. Methods:This was a retrospective observational study. Data was collected from theatre records, MDT outcomes, clinical records, HIPE system and postoperative pathological findings. Inclusion criteria were those with documented clinical and imaging diagnosis of deep pelvic endometriosis. Patients diagnosed with endometriosis who underwent surgical management were reviewed. We analyzed the colorectal work load required in surgical approach in deeply penetrating endometriosis.Results: Total of 28 women (mean age 39, range 26-56), over 3 years period (Jan 2014-Jan with diagnosis of Stage IV endometriosis who had undergone surgical intervention were included in our analysis. A clear majority have complained of pelvic pain (on defecationespecially perimenstrually). Operations included were anterior resection (6), sigmoid colectomy (1), rectovaginal fistula repair (1), appendectomy (1), adhesiolysis (3), and hysterectomy with or without bilateral salphingo-oophorectomy (16). About 42%of the cases had colorectal surgeon's involvement, adhesiolysis or complicated procedure such as anterior resection. Conclusion:Colorectal input is required in significant volume in gynecological endometriosis cases. Studies have shown the surgical treatment of DIE is complex and subject to complications. The surgical expertise of a multidisciplinary team plays a vital role in this setting. For patient safety and medico legal cases it is important to have MDT approach.

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“…First, there is a lack of patient involvement in the discussions, as patients are not present at these meetings, and it must be assured that patient preferences and their social circumstances are taken into account for the most appropriate team decisions. Divergent treatment priorities with a failure to reach a joint recommendation have been commonly reported, as well as poor leadership, insufficient teamwork, time pressures, an absence of key professionals in attendance and the absence of key clinical information; all of which can affect the clinical decision making of MDTs in general 142,143 . MDTs remain a work in progress but continue to add benefit for management during their evolution.…”

Section: [H1] the Pathologists Role In The Mdtmentioning

confidence: 99%

The multidisciplinary management of rectal cancer

Keller

Berho

Perez³

et al. 2020

Nat Rev Gastroenterol Hepatol

223

153

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 As rectal cancer treatment becomes more precise, high-resolution imaging techniques have been established to identify important tumour characteristics that help guide management.  High-resolution magnetic resonance imaging scans are increasingly dictating treatment strategies by providing predictive and prognostic information related to the tumour, and are a standard part of the patient investigation pathway.  Surgical management depends on patient and tumour factors with an aim to optimise function and survival with the lowest risk of recurrence.  Multiple approaches are currently available for resection, including radical surgery involving excision of the rectum and associated mesentery and organsparing techniques involving local excision of the lesion or deferring surgery altogether.  The pathological assessment of the resected rectal cancer specimen provides a level of quality control ensuring that surgical principles have been adhered to and that the surgery was performed in an optimal oncological manner.  Multidisciplinary team presentation of imaging data, evidence-based oncological, surgical and functional recommendations, in addition to pathological assessment of surgical quality, is an essential part of formalised cancer care.

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The role of the multidisciplinary team in the management of deep infiltrating endometriosis

Cited by 30 publications

References 29 publications

The Evolving Role of National Tumor Board – Attitudes of Professionals Towards Multidisciplinary Team Meetings

The Evolving Role of National Tumor Board – Attitudes of Professionals Towards Multidisciplinary Team Meetings

Multidisciplinary Team Approach for the Management of Severe Deeply Infiltrating Endometriosis

The multidisciplinary management of rectal cancer

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