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2020 ; 79
(ä): 309-316
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English Wikipedia
International surgical guidance for COVID-19: Validation using an international
Delphi process - Cross-sectional study
#MMPMID32531308
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Int J Surg
2020[Jul]; 79
(ä): 309-316
PMID32531308
show ga
BACKGROUND: International professional bodies have been quick to disseminate
initial guidance documents during the COVID-19 pandemic. In the absence of firm
evidence, these have been developed by expert committees, limited in participant
number. This study aimed to validate international COVID-19 surgical guidance
using a rapid Delphi consensus exercise. METHODS: Delphi statements were directly
mapped to guidance from surgical professional bodies in the US and Europe
(SAGES/EAES), the UK (Joint RCS), and Australasia (RACS), to validate content
against international consensus. Agreement from ?70% participants was determined
as consensus agreement. RESULTS: The Delphi exercise was completed by 339
individuals from 41 countries and 52 statements were mapped to the guidance, 47
(90.4%) reaching consensus agreement. Of these, 27 statements were mapped to
SAGES/EAES guidance, 21 to the Joint RCS document, and 33 to the RACS document.
Within the SAGES/EAES document, 92.9% of items reached consensus agreement
(median 89.0%, range 60.5-99.2%), 90.4% within the Joint RCS document (87.6%,
63.4-97.9%), and 90.9% within the RACS document (85.5%, 18.7-98.8%). Statements
lacking consensus related to the surgical approach (open vs. laparoscopic), dual
consultant operating, separate instrument decontamination, and stoma formation
rather than anastomosis. CONCLUSION: Initial surgical COVID-19 guidance from the
US, Europe and Australasia was widely supported by an international expert
community, although a small number of contentious areas emerged. These findings
should be addressed in future guidance iterations, and should stimulate urgent
investigation of non-consensus areas.