Evidence map›Paper›PMID 38148401›Full record

ArticleSurgical endoscopy2024

An international Delphi consensus for surgical quality assessment of lymphadenectomy and anastomosis in minimally invasive total gastrectomy for gastric cancer.

Amila Cizmic, Ivan Romic, Andrea Balla, Nicolò Barabino, Gabriele Anania, Gian Luca Baiocchi, Branko Bakula, Carmen Balagué, Felix Berlth, Vasile Bintintan and 28 more

Abstract readConsensus Statement
In one paragraph

Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

38 authors.

Amila CizmicDepartment of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany. a.cizmic@uke.de.ORCID 0000-0002-0925-2330
Ivan RomicDepartment of Hepatobiliary Surgery & Liver Transplantation, University Hospital Centre Zagreb, Zagreb, Croatia.
Andrea BallaColoproctology and Inflammatory Bowel Disease Surgery Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Nicolò BarabinoDepartment of Surgical Sciences & Integrated Diagnostic, University of Genoa, Genoa, Italy.
Gabriele AnaniaDepartment of Medical Science, University of Ferrara, 4121, Ferrara, Italy.
Gian Luca BaiocchiDepartment of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Branko BakulaDepartment of Surgery, University Hospital Sveti Duh, Zagreb, Croatia.
Carmen BalaguéDepartment of General and Digestive Surgery, Hospital de la Santa Creu I Sant Pau, Autonomous University of Barcelona, Barcelona, Spain.
Felix BerlthDepartment of General, Visceral and Transplant Surgery, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
Vasile BintintanDepartment of Surgery, University Hospital Cluj Napoca, Cluj-Napoca, Romania.
Umberto BracaleGeneral and Emergency Surgical Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, AOU San Giovanni and Ruggi D'Aragona, Salerno, Italy.
Jan-Hendrik EgbertsDepartment of Surgery, Israelit Hospital, Hamburg, Germany.
Hans F FuchsDepartment of General, Visceral, Cancer and Transplantation Surgery, University Hospital Cologne, Cologne, Germany.
Suzanne S GisbertzDepartment of Surgery, Amsterdam UMC Location, University of Amsterdam, Amsterdam, The Netherlands.
Ines GockelDepartment of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany.
Peter GrimmingerDepartment of General, Visceral and Transplant Surgery, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
Richard van HillegersbergDepartment of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Noriyuki InakiDepartment of Gastrointestinal Surgery/Breast Surgery, Kanazawa University Hospital, Kanazawa, Ishikawa, Japan.
Arul ImmanuelNorthern Oesophago-Gastric Unit, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle Upon Tyne, UK.
Daniel KorrDepartment of Surgery, Israelit Hospital, Hamburg, Germany.
Philipp LingohrDepartment for General, Visceral, Thoracic and Vascular Surgery, University Hospital of Bonn, Bonn, Germany.
Pietro MascagniFondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Nathaniel MellingDepartment of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Marco MiloneDepartment of Clinical Medicine and Surgery, University of Naples "Federico II", 80131, Naples, Italy.
Yoav MintzDepartment of General Surgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
Salvador Morales-CondeDepartment of General and Digestive Surgery, University Hospital Virgen Macarena, School of Medicine of the University of Seville, Seville, Spain.
Yusef MoullaDepartment of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany.
Beat P Müller-StichDepartment of Digestive Surgery, University Digestive Healthcare Center Basel, Basel, Switzerland.
Kiyokazu NakajimaDepartment of Next Generation Endoscopic Intervention, Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Magnus NilssonDepartment of Clinical Science, Intervention and Technology, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
Matthias ReehDepartment of General, Visceral and Vascular Surgery, Marienkrankenhaus, Hamburg, Germany.
Pierpaolo SileriColoproctology and Inflammatory Bowel Disease Surgery Unit, IRCCS San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.
Eduardo M TargaronaSurgery Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Yuki UshimaruDepartment of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Young-Woo KimCenter for Gastric Cancer, National Cancer Center, Goyang, Gyeonggi, Republic of Korea.
Sheraz MarkarNuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
Felix NickelDepartment of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Anuja T MitraDepartment of Surgery & Cancer, Imperial College London, London, UK.

Funding

Medical Research Council MR/W015838/1
6 · The paper itself

Abstract

backgroundMinimally invasive total gastrectomy (MITG) is a mainstay for curative treatment of patients with gastric cancer. To define and standardize optimal surgical techniques and further improve clinical outcomes through the enhanced MITG surgical quality, there must be consensus on the key technical steps of lymphadenectomy and anastomosis creation, which is currently lacking. This study aimed to determine an expert consensus from an international panel regarding the technical aspects of the performance of MITG for oncological indications using the Delphi method.

methodsA 100-point scoping survey was created based on the deconstruction of MITG into its key technical steps through local and international expert opinion and literature evidence. An international expert panel comprising upper gastrointestinal and general surgeons participated in multiple rounds of a Delphi consensus. The panelists voted on the issues concerning importance, difficulty, or agreement using an online questionnaire. A priori consensus standard was set at > 80% for agreement to a statement. Internal consistency and reliability were evaluated using Cronbach's α.

resultsThirty expert upper gastrointestinal and general surgeons participated in three online Delphi rounds, generating a final consensus of 41 statements regarding MITG for gastric cancer. The consensus was gained from 22, 12, and 7 questions from Delphi rounds 1, 2, and 3, which were rephrased into the 41 statetments respectively. For lymphadenectomy and aspects of anastomosis creation, Cronbach's α for round 1 was 0.896 and 0.886, and for round 2 was 0.848 and 0.779, regarding difficulty or importance.

conclusionsThe Delphi consensus defined 41 steps as crucial for performing a high-quality MITG for oncological indications based on the standards of an international panel. The results of this consensus provide a platform for creating and validating surgical quality assessment tools designed to improve clinical outcomes and standardize surgical quality in MITG.

Indexed as

Stomach NeoplasmsAnastomosis, SurgicalDelphi TechniqueGastrectomyHumansLymph Node ExcisionReproducibility of ResultsConsensusDelphiGastrectomyInternationalLaparoscopyLymphadenectomyMinimally invasive surgerySurgical quality assessmentTechnical skills

Identifiers

PMID38148401
PMCPMC10830761

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.