Defining Major Surgery: A Delphi Consensus Among European Surgical Association (ESA) Members.

Details

Serval ID
serval:BIB_DBE40729AC6B
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Defining Major Surgery: A Delphi Consensus Among European Surgical Association (ESA) Members.
Journal
World journal of surgery
Author(s)
Martin D., Mantziari S., Demartines N., Hübner M.
Working group(s)
ESA Study Group
Contributor(s)
Bismuth H., Sarr M.G., Strasberg S.M., Wexner S.D., Adham M., Altomare D.F., Andersson R., Bechstein W., Biondo S., Bockhorn M., Bonavina L., Rituerto D.C., Clavien P.A., De Manzini N., Decker G., Dejong C.H., Dervenis C., Farges O., Figueras J., Fingerhut A.L., Friess H., Glehen O., Gnant M., Gutschow C., Hahnloser D., Hamberger B., Hamming J.F., Hölscher A.H., Izbicki J.R., Jonas S., Karamarkovic A., Kehlet H., Leppäniemi A.K., Lerut J., Line P.D., Lodge JPA, Meakins J.L., Montorsi M., Nafteux P., Naredi P., Oláh A., Panis Y., Pardo F., Parks R.W., Pedrazzoli S., Pessaux P., Marques H.P., Poggioli G., Popescu I., Puolakkainen P.A., Ramia Angel J.M., Rasanen J., Reynolds J.V., Rosati R., Saeger H.D., Schneeberger S., Schneider P.M., Søreide K., Stippel D., Toso C., Tuech J.J., Tukiainen E.J., Van Hillegersberg R., Wijnhoven B., Winter D.C., Zaninotto G.
ISSN
1432-2323 (Electronic)
ISSN-L
0364-2313
Publication state
Published
Issued date
07/2020
Peer-reviewed
Oui
Volume
44
Number
7
Pages
2211-2219
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Major surgery is a term frequently used but poorly defined. The aim of the present study was to reach a consensus in the definition of major surgery within a panel of expert surgeons from the European Surgical Association (ESA).
A 3-round Delphi process was performed. All ESA members were invited to participate in the expert panel. In round 1, experts were inquired by open- and closed-ended questions on potential criteria to define major surgery. Results were analyzed and presented back anonymously to the panel within next rounds. Closed-ended questions in round 2 and 3 were either binary or statements to be rated on a Likert scale ranging from 1 (strong disagreement) to 5 (strong agreement). Participants were sent 3 reminders at 2-week intervals for each round. 70% of agreement was considered to indicate consensus.
Out of 305 ESA members, 67 (22%) answered all the 3 rounds. Significant comorbidities were the only preoperative factor retained to define major surgery (78%). Vascular clampage or organ ischemia (92%), high intraoperative blood loss (90%), high noradrenalin requirements (77%), long operative time (73%) and perioperative blood transfusion (70%) were procedure-related factors that reached consensus. Regarding postoperative factors, systemic inflammatory response (76%) and the need for intensive or intermediate care (88%) reached consensus. Consequences of major surgery were high morbidity (>30% overall) and mortality (>2%).
ESA experts defined major surgery according to extent and complexity of the procedure, its pathophysiological consequences and consecutive clinical outcomes.
Keywords
Aged, Consensus, Delphi Technique, Europe, Humans, Male, Middle Aged, Societies, Medical, Surgeons, Surgical Procedures, Operative/methods
Pubmed
Web of science
Create date
02/04/2020 17:15
Last modification date
23/04/2021 20:12
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