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

Sivesh K. Kamarajah; Imran Mohamed; Dmitri Nepogodiev; Richard P. T. Evan; James Hodson; Ewen A. Griffiths; Pritam Singh; Derek Alderson; James Bundred; James Gossage; Benjamin Jefferies; Siobhan McKay; Kobby Siaw-Acheampong; Richard van Hillegersberg; Ravinder Vohra; Kasun Wanigsooriya; Tony Whitehouse; A. Bekele; M. P. Achiam; H. Ahmed; A. Ainsworth; K. Akhtar; N. Akkapulu; W. Al-Khyatt; M. Alasmar; B. N. Alemu; R. Alfieri; B. Alkhaffaf; L. S. Alvarez; V. Amahu; N. A. Andreollo; F. Arias; A. Ariyarathenam; A. Arndt; A. Athanasiou; J. S. Azagra; C. Baban; R. Babor; E. Baili; A. Balla; E. Beenen; M. Bendixen; J. Bennett; D. Bergeat; A. J. Bernardes; D. Bernardi; R. Berrisford; A. Bianchi; M. Bjelovic; N. Merrett; null et al

doi:10.1093/bjs/znaa034

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

Sivesh K. Kamarajah, Imran Mohamed, Dmitri Nepogodiev, Richard P. T. Evan, James Hodson, Ewen A. Griffiths, Pritam Singh, Derek Alderson, James Bundred, James Gossage, Benjamin Jefferies, Siobhan McKay, Kobby Siaw-Acheampong, Richard van Hillegersberg, Ravinder Vohra, Kasun Wanigsooriya, Tony Whitehouse, A. Bekele, M. P. Achiam, H. AhmedA. Ainsworth, K. Akhtar, N. Akkapulu, W. Al-Khyatt, M. Alasmar, B. N. Alemu, R. Alfieri, B. Alkhaffaf, L. S. Alvarez, V. Amahu, N. A. Andreollo, F. Arias, A. Ariyarathenam, A. Arndt, A. Athanasiou, J. S. Azagra, C. Baban, R. Babor, E. Baili, A. Balla, E. Beenen, M. Bendixen, J. Bennett, D. Bergeat, A. J. Bernardes, D. Bernardi, R. Berrisford, A. Bianchi, M. Bjelovic, N. Merrett, et al

Western Sydney University

Research output: Contribution to journal › Article › peer-review

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 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.

Original language	English
Pages (from-to)	66-73
Number of pages	8
Journal	British Journal of Surgery
Volume	108
Issue number	1
DOIs	https://doi.org/10.1093/bjs/znaa034
Publication status	Published - 2021

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Kamarajah, S. K., Mohamed, I., Nepogodiev, D., Evan, R. P. T., Hodson, J., Griffiths, E. A., Singh, P., Alderson, D., Bundred, J., Gossage, J., Jefferies, B., McKay, S., Siaw-Acheampong, K., van Hillegersberg, R., Vohra, R., Wanigsooriya, K., Whitehouse, T., Bekele, A., Achiam, M. P., ... et al (2021). Anastomotic leak following oesophagectomy : research priorities from an international Delphi consensus study. British Journal of Surgery, 108(1), 66-73. https://doi.org/10.1093/bjs/znaa034

@article{4b00be3db27a4e5eb126313dadba6df5,

title = "Anastomotic leak following oesophagectomy : research priorities from an international Delphi consensus study",

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 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.",

author = "Kamarajah, {Sivesh K.} and Imran Mohamed and Dmitri Nepogodiev and Evan, {Richard P. T.} and James Hodson and Griffiths, {Ewen A.} and Pritam Singh and Derek Alderson and James Bundred and James Gossage and Benjamin Jefferies and Siobhan McKay and Kobby Siaw-Acheampong and {van Hillegersberg}, Richard and Ravinder Vohra and Kasun Wanigsooriya and Tony Whitehouse and A. Bekele and Achiam, {M. P.} and H. Ahmed and A. Ainsworth and K. Akhtar and N. Akkapulu and W. Al-Khyatt and M. Alasmar and Alemu, {B. N.} and R. Alfieri and B. Alkhaffaf and Alvarez, {L. S.} and V. Amahu and Andreollo, {N. A.} and F. Arias and A. Ariyarathenam and A. Arndt and A. Athanasiou and Azagra, {J. S.} and C. Baban and R. Babor and E. Baili and A. Balla and E. Beenen and M. Bendixen and J. Bennett and D. Bergeat and Bernardes, {A. J.} and D. Bernardi and R. Berrisford and A. Bianchi and M. Bjelovic and N. Merrett and {et al}",

year = "2021",

doi = "10.1093/bjs/znaa034",

language = "English",

volume = "108",

pages = "66--73",

journal = "British Journal of Surgery",

issn = "1365-2168",

publisher = "Oxford University Press",

number = "1",

}

Kamarajah, SK, Mohamed, I, Nepogodiev, D, Evan, RPT, Hodson, J, Griffiths, EA, Singh, P, Alderson, D, Bundred, J, Gossage, J, Jefferies, B, McKay, S, Siaw-Acheampong, K, van Hillegersberg, R, Vohra, R, Wanigsooriya, K, Whitehouse, T, Bekele, A, Achiam, MP, Ahmed, H, Ainsworth, A, Akhtar, K, Akkapulu, N, Al-Khyatt, W, Alasmar, M, Alemu, BN, Alfieri, R, Alkhaffaf, B, Alvarez, LS, Amahu, V, Andreollo, NA, Arias, F, Ariyarathenam, A, Arndt, A, Athanasiou, A, Azagra, JS, Baban, C, Babor, R, Baili, E, Balla, A, Beenen, E, Bendixen, M, Bennett, J, Bergeat, D, Bernardes, AJ, Bernardi, D, Berrisford, R, Bianchi, A, Bjelovic, M, Merrett, N & et al 2021, 'Anastomotic leak following oesophagectomy : research priorities from an international Delphi consensus study', British Journal of Surgery, vol. 108, no. 1, pp. 66-73. https://doi.org/10.1093/bjs/znaa034

TY - JOUR

T1 - Anastomotic leak following oesophagectomy : research priorities from an international Delphi consensus study

AU - Kamarajah, Sivesh K.

AU - Mohamed, Imran

AU - Nepogodiev, Dmitri

AU - Evan, Richard P. T.

AU - Hodson, James

AU - Griffiths, Ewen A.

AU - Singh, Pritam

AU - Alderson, Derek

AU - Bundred, James

AU - Gossage, James

AU - Jefferies, Benjamin

AU - McKay, Siobhan

AU - Siaw-Acheampong, Kobby

AU - van Hillegersberg, Richard

AU - Vohra, Ravinder

AU - Wanigsooriya, Kasun

AU - Whitehouse, Tony

AU - Bekele, A.

AU - Achiam, M. P.

AU - Ahmed, H.

AU - Ainsworth, A.

AU - Akhtar, K.

AU - Akkapulu, N.

AU - Al-Khyatt, W.

AU - Alasmar, M.

AU - Alemu, B. N.

AU - Alfieri, R.

AU - Alkhaffaf, B.

AU - Alvarez, L. S.

AU - Amahu, V.

AU - Andreollo, N. A.

AU - Arias, F.

AU - Ariyarathenam, A.

AU - Arndt, A.

AU - Athanasiou, A.

AU - Azagra, J. S.

AU - Baban, C.

AU - Babor, R.

AU - Baili, E.

AU - Balla, A.

AU - Beenen, E.

AU - Bendixen, M.

AU - Bennett, J.

AU - Bergeat, D.

AU - Bernardes, A. J.

AU - Bernardi, D.

AU - Berrisford, R.

AU - Bianchi, A.

AU - Bjelovic, M.

AU - Merrett, N.

AU - et al, null

PY - 2021

Y1 - 2021

N2 - 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.

AB - 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.

UR - https://hdl.handle.net/1959.7/uws:62916

U2 - 10.1093/bjs/znaa034

DO - 10.1093/bjs/znaa034

M3 - Article

SN - 1365-2168

SN - 0007-1323

VL - 108

SP - 66

EP - 73

JO - British Journal of Surgery

JF - British Journal of Surgery

IS - 1

ER -

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

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