Page 171 - Hospital Authority Convention 2017

Masterclasses

M9.3 Advances in Colorectal Cancer Management 09:00 Room 221

Cancer Case Manager Programme (Colorectal)
Pang YK
Department of Surgery, Queen Elizabeth Hospital, Hong Kong HOSPITAL AUTHORITY CONVENTION 2017
Cancer Case Manager (CCM) Programme was endorsed as a new service caring model for cancer patients in Hospital
Authority (HA). There is a patient-centred framework for quality cancer care delivery, which includes cancer case managers
working within multi-disciplinary teams (MDTs), and an integrated clinical information sharing platform in the Clinical
Management Systems (CMS) of HA. Service workflow on breast and colorectal cancer was developed and rolled out in
seven clusters. In line with HA’s strategic service plan, Queen Elizabeth Hospital/Kowloon Central Cluster has joined this
programme and started the service in November 2011. A nurse, the CCM of colorectal cancer serves as patients’ advocates
and acts as a contact point to follow-up patients during the treatment journey by streamlining care pathway and logistic
issues; coordinating the MDTs; and addressing patients’ needs for education, psychosocial support and access to resources.
These are aimed at achieving quality and cost-effective interventions and outcomes. Evaluation on quality of life and patient
satisfaction survey had been conducted with encouraging results and feedback. Enhancement of this programme or
extension to other diseases may be indicated for further discussion.

Reference
Central Oncology Committee Integrated Care Programs Department, Hospital Authority Head Office. (2011). Cancer Case
Manager Program Operation Manual, August 2011.

M9.4 Advances in Colorectal Cancer Management 09:00 Room 221

Robotic Surgery Service
Law WL
Department of Surgery, The University of Hong Kong, Hong Kong

In the recent two to three decades, we have witnessed rapid advances in minimally invasive surgery in the treatment of
colorectal cancer. Significant improvement in postoperative recovery without compromising the oncologic outcome has
been achieved. In Hong Kong, there is a wide application of minimally invasive surgery for colorectal cancer and over 60% of
colorectal resections are performed using laparoscopic approach in Hospital Authority (HA) hospitals.
However, rectal cancer surgery is a challenging procedure and the quality of the operation has significant impact on the
oncologic outcomes. The laparoscopic approach is possible but this is a complex operation with a steep learning curve. This Wednesday, 17 May
results in a high conversion rate and a suboptimal specimen in laparoscopic resection.
Robotic assisted surgery has been demonstrated to overcome some limitations of conventional laparoscopic rectal cancer
surgery. The stable platform with 3D vision together with versatile instruments, which possess 7 degrees of freedom of
movement, make robotic-assisted surgery very suitable for pelvic dissection.

Robotic surgery has been increasingly applied to rectal cancer surgery and favourable results have been reported worldwide.
In Hong Kong, robotic rectal cancer surgery began more than 10 years ago and now it is commonly applied in hospitals
which have the surgical robotic system. A credentialing system for the surgeons has also been developed in the HA.

We have performed over 300 cases in Queen Mary Hospital and favourable results have been achieved. Robotic rectal
surgery is associated with low conversion rate and confers the benefit of better autonomic nerve preservation. The rate of
positive circumferential margin is also low. Moreover, the procedure is associated a short learning curve for young novice
surgeons. The long-term survival is comparable to laparoscopic resection. More complex procedures can be performed with
the surgical robotic system.

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