Presentation is loading. Please wait.

Presentation is loading. Please wait.

MDT I AARHUS Søren Laurberg Professor of Surgery Aarhus University Hospital Denmark.

Similar presentations


Presentation on theme: "MDT I AARHUS Søren Laurberg Professor of Surgery Aarhus University Hospital Denmark."— Presentation transcript:

1 MDT I AARHUS Søren Laurberg Professor of Surgery Aarhus University Hospital Denmark

2 MDT I AARHUS Evolving process Evolving process Background Background MR rectum MR rectum Selective 5x5 Selective 5x5

3 MDT I AARHUS DECISION MDT DECISION MDT Rectal, recurrent,anal, sarcoma,hipec, rare tumours Rectal, recurrent,anal, sarcoma,hipec, rare tumours Colonic cancer Colonic cancer FOLLOW-UP MDT FOLLOW-UP MDT INTERNATIONAL MDT INTERNATIONAL MDT

4 PRIMARY RECTAL CANCER- SIMPEL CT/MR request, information letter CT/MR request, information letter Letter: date of visit,pt questionnaire Letter: date of visit,pt questionnaire 1. visit 1. visit Diagnose,proctoscopy and notes, anaesthesiologist Diagnose,proctoscopy and notes, anaesthesiologist CT- MR CT- MR MDT conference ( 2x week) MDT conference ( 2x week) 2. visit 2. visit Treatment plan Treatment plan Check lists Check lists

5 ENDOSKOPI Horsens surgery Åthus CT og MR oplysninger, endoskopi og ASA faxes og tlff CT og MR oplysninger, endoskopi og ASA faxes og tlff Pt oplyses skriftligt om plan i Århus – udfylder selvdeklaration Pt oplyses skriftligt om plan i Århus – udfylder selvdeklaration Biopsi svar kirurg anæstesi Biopsi svar kirurg anæstesi Ct-MR-1-2 dage Ct-MR-1-2 dage MDT og svar MDT og svar

6 MDT DECISION CONFERENCE ↑ treatment of patients ↑ treatment of patients ↑ quality of investigations ↑ quality of investigations Better inter and intra disciplinary collaboration Better inter and intra disciplinary collaboration Better decision Better decision ↑teaching ↑teaching

7 MDT DECISION CONFERENCE 2 x week cases app. 60 min Primary RC /Anal cancer Primary RC /Anal cancer Treatment plan Treatment plan Re-evaluation neo-adjuvant therapy Re-evaluation neo-adjuvant therapy Stick to the strategy? Stick to the strategy? Recurrent and advanced cancers Recurrent and advanced cancers See them?, strategy? Progression? See them?, strategy? Progression? Sarcoma, pseudomyxoma rare tumours Sarcoma, pseudomyxoma rare tumours See them?, strategy? See them?, strategy?

8 1 IDENTIFICATION OF CASE

9 2 PRESENTATION OF CASE COLORECTAL FELLOW COLORECTAL FELLOW STANDARDISED PROFORMA STANDARDISED PROFORMA

10 3 PRESENTATION OF CT

11 PRESENTATION OF CT CT FIRST- curative, complex or palliative? CT FIRST- curative, complex or palliative? ONLY CLEAR DECISIONS: ONLY CLEAR DECISIONS: No suspicion No suspicion Metastasis Metastasis Suspicion Suspicion Further investigations Further investigations Control in 3 months Control in 3 months Evaluation by other Evaluation by other

12 4 PRESENTATION OF MR

13 PRESENTATION OF MR Follows a proforma Follows a proforma Clear decisions Clear decisions

14 5 DISCUSSION Palliative- curative Palliative- curative Neoadjuvant (standard/short course+delayed) Neoadjuvant (standard/short course+delayed) Direct surgery (PME, TME,APE,Evtended) Direct surgery (PME, TME,APE,Evtended) Minor treatment (contact,TEM) Minor treatment (contact,TEM) VRAM, brachy, TPE,sacral resection VRAM, brachy, TPE,sacral resection Complex: involving hepar, lung Complex: involving hepar, lung

15 6 SUMMARY, CONCLUSION, ACTION LOUD AND CLEAR LOUD AND CLEAR Decision clear to all Decision clear to all Mistakes are recognized Mistakes are recognized Action Action Who is going to see the patient? Who is going to see the patient? Who will contact other departments directly? Who will contact other departments directly? Time for first visit in oncology decided? Time for first visit in oncology decided?

16 7. INFORMATION MDT FRIDAY 8-9 MDT FRIDAY 8-9 CLINIC AFTER 10 CLINIC AFTER 10 DECISION DIRECTLY TO REFERRAL DECISION DIRECTLY TO REFERRAL TELEPHONE PTS TELEPHONE PTS MDT TUESDAY MDT TUESDAY NEXT DAY NEXT DAY DECISION DIRECTLY TO REFERRAL DECISION DIRECTLY TO REFERRAL TELEPHONE PTS TELEPHONE PTS

17

18 CHECK LIST AIM AIM IT IS EASY, FAST AND UNIFORM IT IS EASY, FAST AND UNIFORM WE DO NOT FORGET THINGS WE DO NOT FORGET THINGS WE DOCUMENT THAT PTS ARE INFORMED WE DOCUMENT THAT PTS ARE INFORMED

19

20

21

22

23 NURSE-RANDOMIZED TRIAL Contact nurse Contact nurse Case manager Case manager

24 2.COLON CANCER SURGEONS –RADIOLOGIST-DAILY SURGEONS –RADIOLOGIST-DAILY Direct surgery-lap? Direct surgery-lap? MDT? CRC?-LIVER? MDT? CRC?-LIVER?

25 QUALITY CONTROL 1 hour every second week 1 hour every second week Study max 10 cases-rectum and colon Study max 10 cases-rectum and colon AIM: AIM: Quality of MR Quality of MR Quality of surgery Quality of surgery Grading CME,PME,TME,APE Grading CME,PME,TME,APE Extend of resection Extend of resection Cebtral ligation? Cebtral ligation?

26

27

28 INTERNATIONAL MDT INTERNATIONAL DATABASE INTERNATIONAL DATABASE Advanced recurrent cancer Advanced recurrent cancer Trials Trials Observational studies Observational studies

29

30


Download ppt "MDT I AARHUS Søren Laurberg Professor of Surgery Aarhus University Hospital Denmark."

Similar presentations


Ads by Google