定义结直肠手术后吻合口漏：全国调查结果。
Defining Anastomotic Leaks After Colorectal Surgery: Results of a National Survey.
机构信息
Division of Colon and Rectal Surgery, Department of Surgery, University of Massachusetts Medical School, Worcester, Massachusetts.
Division of Colon and Rectal Surgery, Department of Surgery, University of Massachusetts Medical School, Worcester, Massachusetts.
出版信息
J Surg Res. 2021 May;261:242-247. doi: 10.1016/j.jss.2020.11.047. Epub 2021 Jan 15.
BACKGROUND
Anastomotic leaks are a dreaded complication after colorectal surgery. Although anastomotic leak is often used as a metric to compare patient outcomes, a standard definition does not exist.
MATERIALS AND METHODS
A web-based survey was developed and distributed to US surgeons. Respondents were queried on the definition of anastomotic leaks using a 5-point Likert scale to rate different scenarios related to colorectal surgery.
RESULTS
Of potential 2209 respondents, 649 (29%) responded to the survey. The majority of respondents was men (76%) and practiced colon and rectal surgery as their primary specialty (89%). Contrast extravasation at the anastomosis, regardless of timing related to the surgery, is the clinical scenario with greatest consensus (>85%). 50% of surgeons do not believe that an abscess near the anastomosis in an asymptomatic patient defines a leak.
CONCLUSIONS
These results highlight the pressing need for standardization of the anastomotic leak definition given the implications on outcomes measurement, research trials, and health care reimbursement.
背景
吻合口漏是结直肠手术后一种可怕的并发症。尽管吻合口漏常被用作比较患者结局的指标，但目前尚缺乏统一的定义。
材料与方法
我们开发了一个基于网络的调查，并分发给美国外科医生。采用 5 分李克特量表来评估与结直肠手术相关的不同场景，询问受访者对吻合口漏的定义。
结果
在潜在的 2209 名受访者中，有 649 名（29%）对调查做出了回应。大多数受访者为男性（76%），且主要从事结肠直肠外科手术（89%）。吻合口对比剂外渗，无论与手术时间的关系如何，是最具共识的临床场景（>85%）。50%的外科医生认为，在无症状患者中，吻合口附近的脓肿不能定义为漏。
结论
鉴于吻合口漏定义对结局测量、研究试验和医疗保健报销的影响，这些结果突出表明需要对吻合口漏定义进行标准化。
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