Defining Major Surgery: A Delphi Consensus Among European Surgical Association (ESA) Members

Autor: Martin, D., Mantziari, S., Demartines, N., Hubner, M., Bismuth, H., Sarr, M. G., Strasberg, S. M., Wexner, S. D., Adham, M., Altomare, D. F., Andersson, R., Bechstein, W., Biondo, S., Bockhorn, M., Bonavina, L., Rituerto, D. C., Clavien, P. -A., De Manzini, N., Decker, G., Dejong, C. H., Dervenis, C., Farges, O., Figueras, J., Fingerhut, A. L., Friess, H., Glehen, O., Gnant, M., Gutschow, C., Hahnloser, D., Hamberger, B., Hamming, J. F., Holscher, A. H., Izbicki, J. R., Jonas, S., Karamarkovic, A., Kehlet, H., Leppaniemi, A. K., Lerut, J., Line, P. -D., Lodge, J. P. A., Meakins, J. L., Montorsi, M., Nafteux, P., Naredi, P., Olah, A., Panis, Y., Pardo, F., Parks, R. W., Pedrazzoli, S., Pessaux, P., Marques, H. P., Poggioli, G., Popescu, I., Puolakkainen, P. A., Ramia Angel, J. M., Rasanen, J., Reynolds, J. V., Rosati, R., Saeger, H. -D., Schneeberger, S., Schneider, P. M., Soreide, K., Stippel, D., Toso, C., Tuech, J. -J., Tukiainen, E. J., Van Hillegersberg, R., Wijnhoven, B., Winter, D. C., Zaninotto, G.
Přispěvatelé: Surgery, Martin, D., Mantziari, S., Demartines, N., Hubner, M., Bismuth, H., Sarr, M. G., Strasberg, S. M., Wexner, S. D., Adham, M., Altomare, D. F., Andersson, R., Bechstein, W., Biondo, S., Bockhorn, M., Bonavina, L., Rituerto, D. C., Clavien, P. -A., De Manzini, N., Decker, G., Dejong, C. H., Dervenis, C., Farges, O., Figueras, J., Fingerhut, A. L., Friess, H., Glehen, O., Gnant, M., Gutschow, C., Hahnloser, D., Hamberger, B., Hamming, J. F., Holscher, A. H., Izbicki, J. R., Jonas, S., Karamarkovic, A., Kehlet, H., Leppaniemi, A. K., Lerut, J., Line, P. -D., Lodge, J. P. A., Meakins, J. L., Montorsi, M., Nafteux, P., Naredi, P., Olah, A., Panis, Y., Pardo, F., Parks, R. W., Pedrazzoli, S., Pessaux, P., Marques, H. P., Poggioli, G., Popescu, I., Puolakkainen, P. A., Ramia Angel, J. M., Rasanen, J., Reynolds, J. V., Rosati, R., Saeger, H. -D., Schneeberger, S., Schneider, P. M., Soreide, K., Stippel, D., Toso, C., Tuech, J. -J., Tukiainen, E. J., Van Hillegersberg, R., Wijnhoven, B., Winter, D. C., Zaninotto, G., Martin D., Mantziari S., Demartines N., Hubner M., Bismuth H., Sarr M.G., Strasberg S.M., Wexner S.D., Adham M., Altomare D.F., Andersson R., Bechstein W., Biondo S., Bockhorn M., Bonavina L., Rituerto D.C., Clavien P.-A., De Manzini N., Decker G., Dejong C.H., Dervenis C., Farges O., Figueras J., Fingerhut A.L., Friess H., Glehen O., Gnant M., Gutschow C., Hahnloser D., Hamberger B., Hamming J.F., Holscher A.H., Izbicki J.R., Jonas S., Karamarkovic A., Kehlet H., Leppaniemi A.K., Lerut J., Line P.-D., Lodge J.P.A., Meakins J.L., Montorsi M., Nafteux P., Naredi P., Olah A., Panis Y., Pardo F., Parks R.W., Pedrazzoli S., Pessaux P., Marques H.P., Poggioli G., Popescu I., Puolakkainen P.A., Ramia Angel J.M., Rasanen J., Reynolds J.V., Rosati R., Saeger H.-D., Schneeberger S., Schneider P.M., Soreide K., Stippel D., Toso C., Tuech J.-J., Tukiainen E.J., Van Hillegersberg R., Wijnhoven B., Winter D.C., Zaninotto G., ESA Study Group, Sarr, M.G., Strasberg, S.M., Wexner, S.D., Altomare, D.F., Rituerto, D.C., Clavien, P.A., Dejong, C.H., Fingerhut, A.L., Hamming, J.F., Hölscher, A.H., Izbicki, J.R., Leppäniemi, A.K., Line, P.D., Lodge, JPA, Meakins, J.L., Oláh, A., Parks, R.W., Marques, H.P., Puolakkainen, P.A., Ramia Angel, J.M., Reynolds, J.V., Saeger, H.D., Schneider, P.M., Søreide, K., Tuech, J.J., Tukiainen, E.J., Winter, D.C., Institut de Recherche sur les Maladies Virales et Hépatiques (IVH), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Zurich, Demartines, Nicolas, Toso, Christian
Rok vydání: 2020
Předmět:
Male
medicine.medical_specialty
Blood transfusion
Consensus
Delphi Technique
medicine.medical_treatment
Delphi method
610 Medicine & health
Consensu
Likert scale
03 medical and health sciences
Surgeon
0302 clinical medicine
Aged
Europe
Humans
Middle Aged
Societies
Medical
Surgeons
Surgical Procedures
Operative/methods
Medical
major surgery
Delphi consensus definition
medicine
Operative / methods
10217 Clinic for Visceral and Transplantation Surgery
Surgical Procedures
ddc:617
business.industry
Perioperative
Vascular surgery
2746 Surgery
3. Good health
Cardiac surgery
Surgery
Cardiothoracic surgery
030220 oncology & carcinogenesis
Surgical Procedures
Operative
030211 gastroenterology & hepatology
Societies
business
[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abdominal surgery
Human
Zdroj: World Journal of Surgery, 44(7), 2211-2219. Springer New York
World journal of surgery, vol. 44, no. 7, pp. 2211-2219
World Journal of Surgery
World Journal of Surgery, 2020, 44 (7), pp.2211-2219. ⟨10.1007/s00268-020-05476-4⟩
World Journal of Surgery, Vol. 44, No 7 (2020) pp. 2211-2219
ISSN: 1432-2323
0364-2313
DOI: 10.1007/s00268-020-05476-4⟩
Popis: Background: Major surgery is a term frequently used but poorly defined. The aim of the present study was to reach a consensus in the definition of major surgery within a panel of expert surgeons from the European Surgical Association (ESA). Methods: A 3-round Delphi process was performed. All ESA members were invited to participate in the expert panel. In round 1, experts were inquired by open- and closed-ended questions on potential criteria to define major surgery. Results were analyzed and presented back anonymously to the panel within next rounds. Closed-ended questions in round 2 and 3 were either binary or statements to be rated on a Likert scale ranging from 1 (strong disagreement) to 5 (strong agreement). Participants were sent 3 reminders at 2-week intervals for each round. 70% of agreement was considered to indicate consensus. Results: Out of 305 ESA members, 67 (22%) answered all the 3 rounds. Significant comorbidities were the only preoperative factor retained to define major surgery (78%). Vascular clampage or organ ischemia (92%), high intraoperative blood loss (90%), high noradrenalin requirements (77%), long operative time (73%) and perioperative blood transfusion (70%) were procedure-related factors that reached consensus. Regarding postoperative factors, systemic inflammatory response (76%) and the need for intensive or intermediate care (88%) reached consensus. Consequences of major surgery were high morbidity (>30% overall) and mortality (>2%). Conclusion: ESA experts defined major surgery according to extent and complexity of the procedure, its pathophysiological consequences and consecutive clinical outcomes.
Databáze: OpenAIRE
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