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01-09-2020 | Original Article

Italian multi-society modified Delphi consensus on the definition and management of anastomotic leakage in colorectal surgery

Authors: Antonino Spinelli, Gabriele Anania, Alberto Arezzo, Stefano Berti, Francesco Bianco, Paolo Pietro Bianchi, Maurizio De Giuli, Paola De Nardi, Paolo de Paolis, Caterina Foppa, Mario Guerrieri, Pierluigi Marini, Roberto Persiani, Diego Piazza, Gilberto Poggioli, Salvatore Pucciarelli, Domenico D’Ugo, Adolfo Renzi, Francesco Selvaggi, Gianfranco Silecchia, Marco Montorsi

Published in: Updates in Surgery | Issue 3/2020

Abstract

Introduction

The incidence of anastomotic leak (AL) has not decreased over the past decades and some important grey areas remain in its definition, prevention, and management. The aim of this study was to reach a national consensus on the definition of AL and to identify key points to be applied in clinical practice.

Methods

A 3-step modified Delphi method was used to establish consensus. Ten representative members of the major Italian surgical scientific societies with proven colorectal expertise were selected after a call to action. After a comprehensive literature search, each expert drew a list of evidence-based statements which were voted in round one by the scientific board. Panel members were asked to mark “totally disagree”, “partially agree” or “totally agree” for each statement and provide comments. The same voting method was used for round 2. Round 3 consisted of a final face-to-face meeting.

Results

Thirty-three statements (clustered into 14 topics) were included in round 1. Following the third voting round, a final list of 16 items was formulated, which encompass the following 9 topics: AL definition, patient- and operative-related risk factors, prevention measures, bowel preparation, surgical technique, intraoperative assessment, early diagnosis, radiological diagnosis and management of specific patterns of AL. The overall response rate was 100% for all items in all the three rounds.

Conclusions

This Delphi survey identified items that expert colorectal surgeons agreed were important to be applied in the prevention, diagnosis, and management of AL. This represents the first consensus involving all relevant national scientific societies, defining important and shared concepts in the diagnosis and management of AL.

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Title: Italian multi-society modified Delphi consensus on the definition and management of anastomotic leakage in colorectal surgery
Authors: Antonino Spinelli
Gabriele Anania
Alberto Arezzo
Stefano Berti
Francesco Bianco
Paolo Pietro Bianchi
Maurizio De Giuli
Paola De Nardi
Paolo de Paolis
Caterina Foppa
Mario Guerrieri
Pierluigi Marini
Roberto Persiani
Diego Piazza
Gilberto Poggioli
Salvatore Pucciarelli
Domenico D’Ugo
Adolfo Renzi
Francesco Selvaggi
Gianfranco Silecchia
Marco Montorsi
Publication date: 01-09-2020
Publisher: Springer International Publishing
Published in: Updates in Surgery / Issue 3/2020
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-020-00837-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Italian multi-society modified Delphi consensus on the definition and management of anastomotic leakage in colorectal surgery

Abstract

Introduction

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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