Definition of colorectal anastomotic leakage: A consensus survey among Dutch and Chinese colorectal surgeons

AIM To determine the level of consensus on the definition of colorectal anastomotic leakage(CAL) among Dutch and Chinese colorectal surgeons.METHODS Dutch and Chinese colorectal surgeons were asked to partake in an online questionnaire. Consensus in the online questionnaire was defined as > 8...

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Published inWorld journal of gastroenterology : WJG Vol. 23; no. 33; pp. 6172 - 6180
Main Authors Rooijen, Stefanus J van, Jongen, Audrey CHM, Wu, Zhou-Qiao, Ji, Jia-Fu, Slooter, Gerrit D, Roumen, Rudi MH, Bouvy, Nicole D
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Inc 07.09.2017
Subjects
Anastomosis, Surgical - adverse effects
Anastomotic Leak - diagnostic imaging
Anastomotic Leak - epidemiology
China - epidemiology
Colon - surgery
Colorectal Neoplasms - surgery
Consensus
Contrast Media - administration & dosage
Humans
Netherlands - epidemiology
Observational Study
Radiography - methods
Rectum - surgery
Reoperation - statistics & numerical data
Surgeons - psychology
Surveys and Questionnaires
Definition
Complication
Colorectal surgery
Colorectal anastomotic leakage
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ISSN1007-9327
2219-2840
2219-2840
DOI10.3748/wjg.v23.i33.6172

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Summary:AIM To determine the level of consensus on the definition of colorectal anastomotic leakage(CAL) among Dutch and Chinese colorectal surgeons.METHODS Dutch and Chinese colorectal surgeons were asked to partake in an online questionnaire. Consensus in the online questionnaire was defined as > 80% agreement between respondents on various statements regarding a general definition of CAL,and regarding clinical and radiological diagnosis of the complication.RESULTS Fifty-nine Dutch and 202 Chinese dedicated colorectal surgeons participated in the online survey. Consensus was found on only one of the proposed elements of a general definition of CAL in both countries: ‘extravasation of contrast medium after rectal enema on a CT scan’. Another two were found relevant according to Dutch surgeons: ‘necrosis of the anastomosis found during reoperation’,and ‘a radiological collection treated with percutaneous drainage’. No consensus was found for all other proposed elements that may be included in a general definition.CONCLUSION There is no universally accepted definition of CAL in the Netherlands and China. Diagnosis of CAL based on clinical manifestations remains a point of discussion in both countries. Dutch surgeons are more likely to report ‘subclinical’ leaks as CAL,which partly explains the higher reported Dutch CAL rates.
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Telephone: +31-40-8886231 Fax: +31-40-8886219
Correspondence to: Dr. Stefanus J van Rooijen, Department of Surgery, Máxima Medical Center, De Run 4600, 5500 MB Veldhoven, the Netherlands. crc.resurge@mmc.nl
Author contributions: van Rooijen SJ, Jongen ACHM and Wu ZQ contributed equally to this work; van Rooijen SJ and Ji JF should be regarded as co-corresponding authors; all authors participated sufficiently in the work to take public responsibility for appropriate portions of the content; van Rooijen SJ, Jongen ACHM and Wu ZQ contributed to drafting of the article and acquisition, analysis, and interpretation of data; Ji JF, Slooter GD, Roumen RMH and Bouvy ND contributed to study concept and design, data interpretation and critical revision of all versions of the manuscript.
ISSN:1007-9327
2219-2840
2219-2840
DOI:10.3748/wjg.v23.i33.6172