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

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

Martin, David (author)

Mantziari, Styliani (author)

Demartines, Nicolas (author)

Hübner, Martin (author)

Bismuth, Henri (author)

Sarr, Michael G. (author)

Strasberg, Steven M. (author)

Wexner, Steven D. (author)

Adham, Mustapha (author)

Altomare, Donato F. (author)

Andersson, Roland (author)

Bechstein, Wolf (author)

Biondo, Sebastiano (author)

Bockhorn, Maximilian (author)

Bonavina, Luigi (author)

Rituerto, Daniel Casanova (author)

Clavien, Pierre Alain (author)

De Manzini, Nicolo (author)

Decker, George (author)

Dejong, Cornelis Hc (author)

Dervenis, Christos (author)

Farges, Olivier (author)

Figueras, Joan (author)

Fingerhut, Abraham Louis (author)

Friess, Helmut (author)

Glehen, Olivier (author)

Gnant, Michael (author)

Gutschow, Christian (author)

Hahnloser, Dieter (author)

Hamberger, Bertil (author)

Hamming, Jacob Frans (author)

Hölscher, Arnulf H. (author)

Izbicki, Jakob R. (author)

Jonas, Sven (author)

Karamarkovic, Aleksandar (author)

Kehlet, Henrik (author)

Leppäniemi, Ari Kalevi (author)

Lerut, Jan (author)

Line, Pål Dag (author)

Lodge, J. Peter A. (author)

Meakins, Jonathan Larmonth (author)

Montorsi, Marco (author)

Nafteux, Philippe (author)

Naredi, Peter, 1955 (author): Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery

Oláh, Attila (author)

Panis, Yves (author)

Pardo, Fernando (author)

Parks, Rowan W. (author)

Pedrazzoli, Sergio (author)

Pessaux, Patrick (author)

Marques, Hugo Pinto (author)

Poggioli, Gilberto (author)

Popescu, Irinel (author)

Puolakkainen, Pauli Antero (author)

Ramia Angel, José M. (author)

Rasanen, Jari (author)

Reynolds, John Vincent (author)

Rosati, Riccardo (author)

Saeger, Hans Detlev (author)

Schneeberger, Stefan (author)

Schneider, Paul M. (author)

Søreide, Kjetil (author)

Stippel, Dirk (author)

Toso, Christian (author)

Tuech, Jean Jacques (author)

Tukiainen, Erkki Juhani (author)

Van Hillegersberg, Richard (author)

Wijnhoven, Bas (author)

Winter, Desmond C. (author)

Zaninotto, Giovanni (author)

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(creator_code:org_t)

2020-03-14
2020
English.
In: World Journal of Surgery. - : Springer Science and Business Media LLC. - 0364-2313 .- 1432-2323. ; 44:7, s. 2211-2219

Related links:: https://serval.unil....; show more...; https://gup.ub.gu.se...; https://doi.org/10.1...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

© 2020, Société Internationale de Chirurgie. Background: 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). Methods: 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. Results: 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%). Conclusion: ESA experts defined major surgery according to extent and complexity of the procedure, its pathophysiological consequences and consecutive clinical outcomes.

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By the author/editor: Martin, David; Mantziari, Styli ...; Demartines, Nico ...; Hübner, Martin; Bismuth, Henri; Sarr, Michael G.; show more...; Strasberg, Steve ...; Wexner, Steven D ...; Adham, Mustapha; Altomare, Donato ...; Andersson, Rolan ...; Bechstein, Wolf; Biondo, Sebastia ...; Bockhorn, Maximi ...; Bonavina, Luigi; Rituerto, Daniel ...; Clavien, Pierre ...; De Manzini, Nico ...; Decker, George; Dejong, Cornelis ...; Dervenis, Christ ...; Farges, Olivier; Figueras, Joan; Fingerhut, Abrah ...; Friess, Helmut; Glehen, Olivier; Gnant, Michael; Gutschow, Christ ...; Hahnloser, Diete ...; Hamberger, Berti ...; Hamming, Jacob F ...; Hölscher, Arnulf ...; Izbicki, Jakob R ...; Jonas, Sven; Karamarkovic, Al ...; Kehlet, Henrik; Leppäniemi, Ari ...; Lerut, Jan; Line, Pål Dag; Lodge, J. Peter ...; Meakins, Jonatha ...; Montorsi, Marco; Nafteux, Philipp ...; Naredi, Peter, 1 ...; Oláh, Attila; Panis, Yves; Pardo, Fernando; Parks, Rowan W.; Pedrazzoli, Serg ...; Pessaux, Patrick; Marques, Hugo Pi ...; Poggioli, Gilber ...; Popescu, Irinel; Puolakkainen, Pa ...; Ramia Angel, Jos ...; Rasanen, Jari; Reynolds, John V ...; Rosati, Riccardo; Saeger, Hans Det ...; Schneeberger, St ...; Schneider, Paul ...; Søreide, Kjetil; Stippel, Dirk; Toso, Christian; Tuech, Jean Jacq ...; Tukiainen, Erkki ...; Van Hillegersber ...; Wijnhoven, Bas; Winter, Desmond ...; Zaninotto, Giova ...; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...

Articles in the publication: World Journal of ...

By the university: University of Gothenburg

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

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