荷兰胃旁路和袖状胃切除术关键步骤的德尔福共识。
A Delphi Consensus of the Crucial Steps in Gastric Bypass and Sleeve Gastrectomy Procedures in the Netherlands.
机构信息
University of Groningen, University Medical Centre Groningen, Post Graduate School of Medicine, Groningen, The Netherlands.
Medical Centre Leeuwarden, Department of Surgery, Leeuwarden, The Netherlands.
出版信息
Obes Surg. 2018 Sep;28(9):2634-2643. doi: 10.1007/s11695-018-3219-7.
PURPOSE
Bariatric procedures are technically complex and skill demanding. In order to standardize the procedures for research and training, a Delphi analysis was performed to reach consensus on the practice of the laparoscopic gastric bypass and sleeve gastrectomy in the Netherlands.
METHODS
After a pre-round identifying all possible steps from literature and expert opinion within our study group, questionnaires were send to 68 registered Dutch bariatric surgeons, with 73 steps for bypass surgery and 51 steps for sleeve gastrectomy. Statistical analysis was performed to identify steps with and without consensus. This process was repeated to reach consensus of all necessary steps.
RESULTS
Thirty-eight participants (56%) responded in the first round and 32 participants (47%) in the second round. After the first Delphi round, 19 steps for gastric bypass (26%) and 14 for sleeve gastrectomy (27%) gained full consensus. After the second round, an additional amount of 10 and 12 sub-steps was confirmed as key steps, respectively. Thirteen steps in the gastric bypass and seven in the gastric sleeve were deemed advisable. Our expert panel showed a high level of consensus expressed in a Cronbach's alpha of 0.82 for the gastric bypass and 0.87 for the sleeve gastrectomy.
CONCLUSIONS
The Delphi consensus defined 29 steps for gastric bypass and 26 for sleeve gastrectomy as being crucial for correct performance of these procedures to the standards of our expert panel. These results offer a clear framework for the technical execution of these procedures.
目的
减重手术技术复杂，要求技能高超。为了规范研究和培训程序，我们进行了一项 Delphi 分析，以就荷兰腹腔镜胃旁路术和袖状胃切除术的实践达成共识。
方法
在预轮中，从我们研究小组的文献和专家意见中确定了所有可能的步骤，然后向 68 名注册的荷兰减肥外科医生发送了问卷，其中包括旁路手术的 73 个步骤和袖状胃切除术的 51 个步骤。进行了统计分析，以确定有和无共识的步骤。这个过程重复进行，以达成所有必要步骤的共识。
结果
38 名参与者（56%）在第一轮中做出了回应，32 名参与者（47%）在第二轮中做出了回应。在第一轮 Delphi 之后，胃旁路术的 19 个步骤（26%）和袖状胃切除术的 14 个步骤（27%）获得了完全共识。在第二轮之后，又分别确认了 10 个和 12 个子步骤是关键步骤。胃旁路术中有 13 个步骤和胃袖状切除术中有 7 个步骤被认为是可取的。我们的专家小组表现出了高度的共识，胃旁路术的 Cronbach's alpha 为 0.82，胃袖状切除术为 0.87。
结论
Delphi 共识确定了胃旁路术的 29 个步骤和袖状胃切除术的 26 个步骤，这些步骤对于按照我们的专家小组的标准正确执行这些程序至关重要。这些结果为这些程序的技术执行提供了一个明确的框架。
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