Protective ileostomy creation after anterior resection of the rectum: Shared decision-making or still subjective?
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Balla Andrea, Saraceno Federica, Rullo Marika, Morales-Conde Salvador, Targarona Soler Eduardo M, Di Saverio Salomone, Guerrieri Mario, Lepiane Pasquale, Di Lorenzo Nicola, Adamina Michel, Alarcón Isaias, Arezzo Alberto, Bollo Rodriguez Jesus, Boni Luigi, Biondo Sebastiano, Carrano Francesco Maria, Chand Manish, Jenkins John T, Davies Justin, Delgado Rivilla Salvadora, Delrio Paolo, Elmore Ugo, Espin-Basany Eloy, Fichera Alessandro, Flor Lorente Blas, Francis Nader, Gómez Ruiz Marcos, Hahnloser Dieter, Licardie Eugenio, Martinez Carmen, Ortenzi Monica, Panis Yves, Pastor Idoate Carlos, Paganini Alessandro M, Pera Miguel, Perinotti Roberto, Popowich Daniel A, Rockall Timothy, Rosati Riccardo, Sartori Alberto, Scoglio Daniele, Shalaby Mostafa, Simó Fernández Vicente, Smart Neil J, Spinelli Antonino, Sylla Patricia, Tanis Pieter J, Valdes-Hernandez Javier, Wexner Steven D, Sileri Pierpaolo
Аннотация
METHOD: Fifty four colorectal surgeons took part in an electronic survey to answer the questions and describe what usually led their decision to perform PI. A content analysis was used to code the answers. To classify answers, five dichotomous categories (In favour/Against PI, Listed/Unlisted RFs, Typical/Atypical, Emotions/Non-emotions, Personal experience/No personal experience) have been developed.
RESULTS: Overall, 76% of surgeons were in favour of PI creation and 88% considered listed RFs in the question of whether to perform PI. Atypical answers were reported in 10% of cases. Emotions and personal experience influenced surgeons' decision-making process in 22% and 49% of cases, respectively. The most frequently considered RFs were the distance of the anastomosis from the anal verge (96%), neoadjuvant chemoradiotherapy (88%), a positive intraoperative leak test (65%), blood loss (37%) and immunosuppression therapy (35%).
CONCLUSION: The indications to perform PI following rectal cancer surgery lack standardization and evidence-based guidelines are required to inform practice. Until then, expert opinion can be helpful to assist the decision-making process in patients who have undergone AR for adenocarcinoma.