European expert consensus on a structured approach to circular stapling anastomosis in minimally invasive left-sided colorectal resection

IF 2.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Colorectal Disease Pub Date : 2025-02-20 DOI:10.1111/codi.70037

Samson Tou, Anthony G. Gallagher, Gabriele Bislenghi, Rui Farinha, Albert Wolthuis, the CAPITAL A Study Collaborative

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Abstract

Aim

The aim of this work is to develop and operationally define performance metrics that characterize a reference approach to circular stapling anastomosis during minimally invasive left-sided colorectal resection and to obtain face and content validity through a consensus meeting.

Method

Three expert colorectal surgeons with advanced experience with minimally invasive surgery, a senior behavioural scientist and a research fellow with experience in performance metrics development formed the Metrics Group. Technical support was provided by device engineers. Published guidelines, training materials, manufacturers' instructions for use and unedited videos of circular stapling anastomosis in minimally invasive left-sided colorectal resection were used to deconstruct the task into defined, observable performance units or metrics (i.e. procedural phases, steps, errors and critical errors). The performance metrics were then subjected to detailed review by 16 expert colorectal surgeons in a modified Delphi process.

Results

Performance metrics for circular stapling anastomosis during minimally invasive left-sided colorectal resection had three procedural phases with 32 steps, 40 errors and 38 critical errors. After the modified Delphi process the agreed performance metrics consisted of three procedural phases, 36 steps, 42 errors and 39 critical errors. A group of expert colorectal surgeons from Europe verified the face and content of these metrics. After discussion, all procedural phases received unanimous consensus by the Delphi panel.

Conclusion

Circular stapling anastomosis during the minimally invasive approach to left-sided colorectal resection can be broken down into procedural phases and steps, with errors and critical errors known as performance metrics. We consider the metrics essential for the development of structured training in using circular stapling anastomosis in the minimally invasive approach to left-sided colorectal resection.

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欧洲专家一致同意采用结构化的环形吻合器吻合术进行左侧结肠直肠癌微创切除术

目的：本研究的目的是制定并从操作上定义性能指标，以确定微创左侧结肠直肠癌切除术中环形吻合器吻合术的参考方法，并通过共识会议获得面部和内容有效性。方法由3名具有微创手术经验的结直肠外科专家、1名资深行为科学家和1名具有绩效指标开发经验的研究员组成metrics小组。由设备工程师提供技术支持。使用已出版的指南、培训材料、制造商使用说明和未经编辑的视频，将圆形吻合器吻合术在微创左侧结肠直肠切除术中的任务解构为定义的、可观察的性能单位或指标（即程序阶段、步骤、错误和关键错误）。16位结直肠外科专家采用改进的德尔菲法对这些指标进行详细评估。结果微创左侧结直肠切除术环形吻合器吻合术的性能指标分为3个阶段，32个步骤，40个错误，38个严重错误。经过改进的德尔菲过程后，商定的绩效指标包括三个程序阶段，36个步骤，42个错误和39个关键错误。一组来自欧洲的结直肠外科专家验证了这些指标的外观和内容。经过讨论，所有程序阶段都得到了德尔菲专家组的一致同意。结论左侧结肠直肠癌微创入路环形吻合器吻合术可分为不同的操作阶段和步骤，其误差和关键误差可作为性能指标。我们认为，在采用圆形吻合器吻合术进行左侧结肠切除术的微创入路中，对结构化训练的发展至关重要。

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来源期刊

Colorectal Disease 医学-胃肠肝病学

CiteScore

6.10

自引率

11.80%

发文量

406

审稿时长

1.5 months

期刊介绍： Diseases of the colon and rectum are common and offer a number of exciting challenges. Clinical, diagnostic and basic science research is expanding rapidly. There is increasing demand from purchasers of health care and patients for clinicians to keep abreast of the latest research and developments, and to translate these into routine practice. Technological advances in diagnosis, surgical technique, new pharmaceuticals, molecular genetics and other basic sciences have transformed many aspects of how these diseases are managed. Such progress will accelerate. Colorectal Disease offers a real benefit to subscribers and authors. It is first and foremost a vehicle for publishing original research relating to the demanding, rapidly expanding field of colorectal diseases. Essential for surgeons, pathologists, oncologists, gastroenterologists and health professionals caring for patients with a disease of the lower GI tract, Colorectal Disease furthers education and inter-professional development by including regular review articles and discussions of current controversies. Note that the journal does not usually accept paediatric surgical papers.