The utility of the delphi method in defining anastomotic leak following colorectal surgery.

Autor: Daniel VT; Division of Colon and Rectal Surgery, Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA., Alavi K; Division of Colon and Rectal Surgery, Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA., Davids JS; Division of Colon and Rectal Surgery, Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA., Sturrock PR; Division of Colon and Rectal Surgery, Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA., Harnsberger CR; Division of Colon and Rectal Surgery, Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA., Steele SR; Department of Colorectal Surgery, Cleveland Clinic, Cleveland, OH, USA., Maykel JA; Division of Colon and Rectal Surgery, Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA. Electronic address: Justin.Maykel@umassmemorial.org.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2020 Jan; Vol. 219 (1), pp. 75-79. Date of Electronic Publication: 2019 May 25.
DOI: 10.1016/j.amjsurg.2019.05.011
Abstrakt: Background: Almost a decade after international guidelines defining anastomotic leak (AL) were published, the definition of AL remains inconsistent.
Methods: A 3-round modified Delphi study was conducted among a national panel of 8 surgeon experts to assess consensus related to the definition of AL following colorectal resection. Consensus was defined when a scenario was rated as very important or absolutely essential by at least 85% of the experts in round 3.
Results: Seven of fifteen (47%) clinical and radiological scenarios of AL achieved consensus. 80% of clinical scenarios reached consensus. 30% of radiological scenarios reached consensus including CT demonstrating air bubbles around the anastomosis. No consensus was achieved in 70% of radiological scenarios.
Conclusions: Consensus on the definition of AL is difficult to reach, in relation to international guidelines; which implies that further refinement of the definition of AL is needed to compare patient outcomes.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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