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

Stefanus J. van Rooijen*, Audrey C. H. M. Jongen, Zhou-Qiao Wu, Jia-Fu Ji, Gerrit D. Slooter, Rudi M. H. Roumen, Nicole D. Bouvy

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

27 Citations (Web of Science)

Abstract

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.

Original languageEnglish
Pages (from-to)6172-6180
Number of pages9
JournalWorld Journal of Gastroenterology
Volume23
Issue number33
DOIs
Publication statusPublished - 7 Sep 2017

Keywords

  • Colorectal anastomotic leakage
  • Colorectal surgery
  • Definition
  • Complication
  • RECTAL-CANCER
  • RISK-FACTORS
  • GASTROINTESTINAL SURGERY
  • ACCURATE PREDICTION
  • ANTERIOR RESECTION
  • INTESTINAL DAMAGE
  • PLASMA MARKERS
  • INFLAMMATION
  • INFECTION
  • SURVIVAL

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