Anastomotic leak following oesophagectomy : research priorities from an international Delphi consensus study
(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
- K. Kamarajah, Sivesh and Singh, Pritam
- contributor
- Johansson, Jan LU
- author collaboration
- organization
- publishing date
- 2021-01-27
- 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
- 2024-09-22 09:11:57
@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}},
}