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Anastomotic leak following oesophagectomy : research priorities from an international Delphi consensus study

K. Kamarajah, Sivesh and Singh, Pritam (2021) In The British journal of surgery 108(1). p.66-73
Abstract

BACKGROUND: The Oesophago-Gastric Anastomosis Audit (OGAA) is an international collaborative group set up to study anastomotic leak outcomes after oesophagectomy for cancer. This Delphi study aimed to prioritize future research areas of unmet clinical need in RCTs to reduce anastomotic leaks.

METHODS: A modified Delphi process was overseen by the OGAA committee, national leads, and engaged clinicians from high-income countries (HICs) and low/middle-income countries (LMICs). A three-stage iterative process was used to prioritize research topics, including a scoping systematic review (stage 1), and two rounds of anonymous electronic voting (stages 2 and 3) addressing research priority and ability to recruit. Stratified analyses were... (More)

BACKGROUND: The Oesophago-Gastric Anastomosis Audit (OGAA) is an international collaborative group set up to study anastomotic leak outcomes after oesophagectomy for cancer. This Delphi study aimed to prioritize future research areas of unmet clinical need in RCTs to reduce anastomotic leaks.

METHODS: A modified Delphi process was overseen by the OGAA committee, national leads, and engaged clinicians from high-income countries (HICs) and low/middle-income countries (LMICs). A three-stage iterative process was used to prioritize research topics, including a scoping systematic review (stage 1), and two rounds of anonymous electronic voting (stages 2 and 3) addressing research priority and ability to recruit. Stratified analyses were performed by country income.

RESULTS: In stage 1, the steering committee proposed research topics across six domains: preoperative optimization, surgical oncology, technical approach, anastomotic technique, enhanced recovery and nutrition, and management of leaks. In stages 2 and stage 3, 192 and 171 respondents respectively participated in online voting. Prioritized research topics include prehabilitation, anastomotic technique, and timing of surgery after neoadjuvant chemo(radio)therapy. Stratified analyses by country income demonstrated no significant differences in research priorities between HICs and LMICs. However, for ability to recruit, there were significant differences between LMICs and HICs for themes related to the technical approach (minimally invasive, width of gastric tube, ischaemic preconditioning) and location of the anastomosis.

CONCLUSION: Several areas of research priority are consistent across LMICs and HICs, but discrepancies in ability to recruit by country income will inform future study design.

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author collaboration
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Anastomotic Leak/etiology, Biomedical Research, Delphi Technique, Esophagectomy/adverse effects, Evidence-Based Medicine, Humans, Research, Surveys and Questionnaires
in
The British journal of surgery
volume
108
issue
1
pages
8 pages
publisher
Oxford University Press
external identifiers
  • pmid:33640931
  • scopus:85111600363
ISSN
1365-2168
DOI
10.1093/bjs/znaa034
language
English
LU publication?
yes
additional info
© The Author(s) 2020. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please email: journals.permissions@oup.com.
id
aa5937a4-1424-4666-9df0-e78b5171ffc9
date added to LUP
2022-09-28 17:33:54
date last changed
2024-09-07 09:05:45
@article{aa5937a4-1424-4666-9df0-e78b5171ffc9,
  abstract     = {{<p>BACKGROUND: The Oesophago-Gastric Anastomosis Audit (OGAA) is an international collaborative group set up to study anastomotic leak outcomes after oesophagectomy for cancer. This Delphi study aimed to prioritize future research areas of unmet clinical need in RCTs to reduce anastomotic leaks.</p><p>METHODS: A modified Delphi process was overseen by the OGAA committee, national leads, and engaged clinicians from high-income countries (HICs) and low/middle-income countries (LMICs). A three-stage iterative process was used to prioritize research topics, including a scoping systematic review (stage 1), and two rounds of anonymous electronic voting (stages 2 and 3) addressing research priority and ability to recruit. Stratified analyses were performed by country income.</p><p>RESULTS: In stage 1, the steering committee proposed research topics across six domains: preoperative optimization, surgical oncology, technical approach, anastomotic technique, enhanced recovery and nutrition, and management of leaks. In stages 2 and stage 3, 192 and 171 respondents respectively participated in online voting. Prioritized research topics include prehabilitation, anastomotic technique, and timing of surgery after neoadjuvant chemo(radio)therapy. Stratified analyses by country income demonstrated no significant differences in research priorities between HICs and LMICs. However, for ability to recruit, there were significant differences between LMICs and HICs for themes related to the technical approach (minimally invasive, width of gastric tube, ischaemic preconditioning) and location of the anastomosis.</p><p>CONCLUSION: Several areas of research priority are consistent across LMICs and HICs, but discrepancies in ability to recruit by country income will inform future study design.</p>}},
  author       = {{K. Kamarajah, Sivesh and Singh, Pritam}},
  issn         = {{1365-2168}},
  keywords     = {{Anastomotic Leak/etiology; Biomedical Research; Delphi Technique; Esophagectomy/adverse effects; Evidence-Based Medicine; Humans; Research; Surveys and Questionnaires}},
  language     = {{eng}},
  month        = {{01}},
  number       = {{1}},
  pages        = {{66--73}},
  publisher    = {{Oxford University Press}},
  series       = {{The British journal of surgery}},
  title        = {{Anastomotic leak following oesophagectomy : research priorities from an international Delphi consensus study}},
  url          = {{http://dx.doi.org/10.1093/bjs/znaa034}},
  doi          = {{10.1093/bjs/znaa034}},
  volume       = {{108}},
  year         = {{2021}},
}