The utility of the delphi method in defining anastomotic leak following colorectal surgery |
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| Institution: | 1. Division of Colon and Rectal Surgery, Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA;2. Department of Colorectal Surgery, Cleveland Clinic, Cleveland, OH, USA;1. Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA;2. Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA;3. UCLA-Caltech Medical Scientist Training Program, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA;4. United Regional Health Care System, Wichita Falls, TX, USA;1. University of Utah Health School of Medicine, Department of Surgery, Salt Lake City, UT, USA;2. University of Utah Health School of Medicine, Salt Lake City, UT, USA;1. Florida Hospital Tampa, Tampa, FL, USA;2. University of Central Florida, Orlando, FL, USA;1. Department of Surgery, School of Medicine, Emory University, Atlanta, GA, USA;2. Winship Cancer Institute, Emory University, Atlanta, GA, USA;1. Division of Surgical Oncology, Oregon Health & Science University, USA;2. Breast Cancer Program, Providence Cancer Institute, USA |
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| Abstract: | BackgroundAlmost a decade after international guidelines defining anastomotic leak (AL) were published, the definition of AL remains inconsistent.MethodsA 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.ResultsSeven 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.ConclusionsConsensus 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. |
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