European consensus on essential steps of Minimally Invasive Ivor Lewis and McKeown Esophagectomy through Delphi methodology
MIE Delphi Collaboration
(2022) Surgical endoscopy, volume 36, issue 1, pp. 446 - 460
(Article)
Abstract
Background: Minimally invasive esophagectomy (MIE) is a complex and technically demanding procedure with a long learning curve, which is associated with increased morbidity and mortality. To master MIE, training in essential steps is crucial. Yet, no consensus on essential steps of MIE is available. The aim of this study was
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to achieve expert consensus on essential steps in Ivor Lewis and McKeown MIE through Delphi methodology. Methods: Based on expert opinion and peer-reviewed literature, essential steps were defined for Ivor Lewis (IL) and McKeown (McK) MIE. In a round table discussion, experts finalized the lists of steps and an online Delphi questionnaire was sent to an international expert panel (7 European countries) of minimally invasive upper GI surgeons. Based on replies and comments, steps were adjusted and rephrased and sent in iterative fashion until consensus was achieved. Results: Two Delphi rounds were conducted and response rates were 74% (23 out of 31 experts) for the first and 81% (27 out of 33 experts) for the second round. Consensus was achieved on 106 essential steps for both the IL and McK approach. Cronbach’s alpha in the first round was 0.78 (IL) and 0.78 (McK) and in the second round 0.92 (IL) and 0.88 (McK). Conclusions: Consensus among European experts was achieved on essential surgical steps for both Ivor Lewis and McKeown minimally invasive esophagectomy.
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Keywords: Consensus, Esophagectomy, Essential steps, Minimally invasive surgery, Upper GI, Esophageal Neoplasms/surgery, Minimally Invasive Surgical Procedures/methods, Humans, Postoperative Complications/surgery, Esophagectomy/methods, Retrospective Studies, Learning Curve, Surgery, Journal Article, Research Support, Non-U.S. Gov't
ISSN: 0930-2794
Publisher: Springer New York
Note: Funding Information: This study has been fully supported and financed by the Radboud University Medical Center, Department of Surgery, Nijmegen, the Netherlands. Funding Information: The authors would like to thank Marja Bulte - ter Meer, PhD for providing Fig. 1 of the manuscript. Collaborators for the MIE Delphi Collaboration M. Asif Chaudry (Department of Surgery, The Royal Marsden, Sutton), E. Cheong (Department of Surgery, Norfolk and Norwich University Hospital, Norwich), F. Daams (Department of Surgery, Amsterdam UMC, VUMC, Amsterdam), M.J. van Det (Department of Surgery, ZGT, Almelo/Hengelo), C. Gutschow (Department of Surgery, USZ, Zürich), J. Heisterkamp (Department of Surgery, ETZ, Tilburg), R. Van Hillegersberg (Department of Surgery, UMC Utrecht, Utrecht), A. Hölscher (Department of Surgery, University Hospital Cologne, Cologne), E.A. Kouwenhoven (Department of Surgery, ZGT, Almelo/Hengelo), M.D.P. Luyer (Department of Surgery, Catharina Hospital, Eindhoven), I.S. Martijnse (Department of Surgery, ETZ, Tilburg), P. Nafteux (Department of Thoracic Surgery, UZ Leuven, Leuven), G.A.P. Nieuwenhuijzen (Department of Surgery, Catharina Hospital, Eindhoven), M. Nilsson (Division of Surgery, Karolinska University Hospital, Stockholm), P. Pattyn (Department of Surgery, UZ Gent, Gent), D.L. van der Peet (Department of Surgery, Amsterdam UMC, VUMC, Amsterdam), J.V. Räsänen (Department of Surgery, Helsinki University Hospital, Helsinki), J.P. Ruurda (Department of Surgery, UMC Utrecht, Utrecht), P. Schneider (Department of Surgery, University Hospital Zürich, Zürich), W. Schröder (Department of Surgery, University Hospital Cologne, Cologne), H. van Veer (Department of Surgery, UZ Leuven, Leuven), B.P.L. Wijnhoven (Department of Surgery, Erasmus MC, Rotterdam). The enlisted collaborators were all part of the Delphi consensus process. They were given the opportunity to review and edit the manuscript and all approved the final version. Publisher Copyright: © 2021, The Author(s).
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