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

Vijaya T Daniel, Karim Alavi, Jennifer S Davids, Paul R Sturrock, Cristina R Harnsberger, Scott R Steele, Justin A Maykel
American Journal of Surgery 2019 May 25

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.


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