An international Delphi consensus for surgical quality assessment of lymphadenectomy and anastomosis in minimally invasive total gastrectomy for gastric cancer
Cizmic, Amila (University Medical Center Hamburg-Eppendorf)
Romic, Ivan (University Hospital Centre Zagreb)
Balla, Andrea (IRCCS San Raffaele Scientific Institute (Milà, Itàlia))
Barabino, Nicolò (University of Genoa)
Anania, Gabriele (University of Ferrara)
Baiocchi, Gian Luca (University of Brescia)
Bakula, Branko (University Hospital Sveti Duh)
Balaguè Ponz, Carmen (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Berlth, Felix (University Medical Center of the Johannes Gutenberg University)
Bintintan, Vasile (University Hospital Cluj Napoca)
Bracale, Umberto (University of Salerno)
Egberts, Jan-Hendrik (Israelit Hospital)
Fuchs, Hans F. (University Hospital Cologne)
Gisbertz, Suzanne S. (Cancer Center Amsterdam)
Gockel, Ines (University Hospital of Leipzig)
Grimminger, Peter (University Medical Center of the Johannes Gutenberg University)
van Hillegersberg, Richard (Utrecht University)
Inaki, Noriyuki (Kanazawa University Hospital)
Immanuel, Arul (Newcastle Upon Tyne Hospitals NHS Trust)
Korr, Daniel (Israelit Hospital)
Lingohr, Philipp (University Hospital of Bonn)
Mascagni, Pietro (IHU-Strasbourg)
Melling, Nathaniel (University Medical Center Hamburg-Eppendorf)
Milone, Marco (University of Naples "Federico II")
Mintz, Yoav (Hadassah Hebrew University Medical Center)
Morales Conde, Salvador (Hospital Quironsalud Sagrado Corazon)
Moulla, Yusef (University Hospital of Leipzig)
Müller-Stich, Beat P. (University Digestive Healthcare Center Basel)
Nakajima, Kiyokazu (Osaka University)
Nilsson, Magnus (Karolinska University Hospital)
Reeh, Matthias (Marienkrankenhaus)
Sileri, Pierpaolo (Vita-Salute University)
Targarona, Eduardo M (Institut d'Investigació Biomèdica Sant Pau)
Ushimaru, Yuki (Osaka University Graduate School of Medicine)
Kim, Young-Woo (National Cancer Center)
Markar, Sheraz (University of Oxford)
Nickel, Felix (University Medical Center Hamburg-Eppendorf)
Mitra, Anuja T. (Imperial College London)
Universitat Autònoma de Barcelona

Fecha:	2023
Resumen:	Minimally invasive total gastrectomy (MITG) is a mainstay for curative treatment of patients with gastric cancer. To define and standardize optimal surgical techniques and further improve clinical outcomes through the enhanced MITG surgical quality, there must be consensus on the key technical steps of lymphadenectomy and anastomosis creation, which is currently lacking. This study aimed to determine an expert consensus from an international panel regarding the technical aspects of the performance of MITG for oncological indications using the Delphi method. A 100-point scoping survey was created based on the deconstruction of MITG into its key technical steps through local and international expert opinion and literature evidence. An international expert panel comprising upper gastrointestinal and general surgeons participated in multiple rounds of a Delphi consensus. The panelists voted on the issues concerning importance, difficulty, or agreement using an online questionnaire. A priori consensus standard was set at > 80% for agreement to a statement. Internal consistency and reliability were evaluated using Cronbach's α. Thirty expert upper gastrointestinal and general surgeons participated in three online Delphi rounds, generating a final consensus of 41 statements regarding MITG for gastric cancer. The consensus was gained from 22, 12, and 7 questions from Delphi rounds 1, 2, and 3, which were rephrased into the 41 statetments respectively. For lymphadenectomy and aspects of anastomosis creation, Cronbach's α for round 1 was 0. 896 and 0. 886, and for round 2 was 0. 848 and 0. 779, regarding difficulty or importance. The Delphi consensus defined 41 steps as crucial for performing a high-quality MITG for oncological indications based on the standards of an international panel. The results of this consensus provide a platform for creating and validating surgical quality assessment tools designed to improve clinical outcomes and standardize surgical quality in MITG. The online version contains supplementary material available at 10. 1007/s00464-023-10614-9.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Consensus ; Delphi ; Gastrectomy ; International ; Laparoscopy ; Lymphadenectomy ; Minimally invasive surgery ; Surgical quality assessment ; Technical skills
Publicado en:	Surgical endoscopy, Vol. 38 (december 2023) , p. 488-498, ISSN 1432-2218

DOI: 10.1007/s00464-023-10614-9
PMID: 38148401

11 p, 678.3 KB

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