Consensus on controversial issues of the surgery for Crohn’s disease by Delphi method

AIM: to establish the consensus on controversial issues of the surgery for Сrohn’s disease by Delphi method.METHODS: a cross-sectional study was conducted by the Delphi method. 62 experts voted intramural and anonymous (31.03.23). 5 statements from the current edition of clinical guidelines were selected for correction by working group and further voting [2]. Based on the practical experience of the working group and literature data, 3 new statements were created also. Statements that do not reach the required level of agreement (80% or more) will be subjected to Round 2 of the Delphi method.RESULTS: all experts took part in the anonymous voting. The panel of experts is represented by 8 different areas of practical medicine and the median of the professional experience of the respondents was 30 (12–49) years. Of the 8 statements submitted for voting, consensus (80% or more) was reached on 6 out of 8. 2 statements have been revised by working group for the distance 2nd round of the Delphi study. Consensus (more than 80%) was reached on both.CONCLUSION: a cross-sectional study by the Delphi method provided the opinions of a panel of experts on controversial issues in the surgical treatment of Crohn’s disease. Statements that reach consensus will be included by the working group in a new edition of clinical guidelines of Crohn’s disease.

[1]  M. Émond,et al.  A Canadian consensus-based list of urgent and specialized in-hospital trauma care interventions to assess the accuracy of prehospital trauma triage protocols: a modified Delphi study , 2023, Canadian journal of surgery. Journal canadien de chirurgie.

[2]  Marco Sonnberger,et al.  Reporting guidelines for Delphi techniques in health sciences: A methodological review. , 2022, Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen.

[3]  V. Annese,et al.  Optimizing biologic therapy in inflammatory bowel disease: a Delphi consensus in the United Arab Emirates , 2021, Therapeutic advances in gastroenterology.

[4]  Weiming Zhu,et al.  Comparison of primary anastomosis and staged surgery in emergency treatment of complicated Crohn's disease , 2020, Journal of digestive diseases.

[5]  Статья Редакционная,et al.  КЛИНИЧЕСКИЕ РЕКОМЕНДАЦИИ ПО ДИАГНОСТИКЕ И ЛЕЧЕНИЮ БОЛЕЗНИ КРОНА У ВЗРОСЛЫХ (ПРОЕКТ) , 2020 .

[6]  P. Neary,et al.  Strictureplasty versus bowel resection for the surgical management of fibrostenotic Crohn’s disease: a systematic review and meta-analysis , 2020, International Journal of Colorectal Disease.

[7]  L. Stassen,et al.  ECCO Guidelines on Therapeutics in Crohn's Disease: Surgical Treatment. , 2019, Journal of Crohn's & colitis.

[8]  C. Buskens,et al.  Persistent Mesorectal Inflammatory Activity is Associated With Complications After Proctectomy in Crohn’s Disease , 2018, Journal of Crohn's & colitis.

[9]  W. Bemelman,et al.  European Crohn's and Colitis Organisation Topical Review on Prediction, Diagnosis and Management of Fibrostenosing Crohn's Disease. , 2016, Journal of Crohn's & colitis.

[10]  J. Burke,et al.  A Meta-analysis of Percutaneous Drainage Versus Surgery as the Initial Treatment of Crohn's Disease-related Intra-abdominal Abscess. , 2016, Journal of Crohn's & colitis.

[11]  W. Bemelman,et al.  A global consensus on the classification, diagnosis and multidisciplinary treatment of perianal fistulising Crohn's disease , 2014, Gut.

[12]  K. Kinoshita,et al.  Time from admission to initiation of surgery for source control is a critical determinant of survival in patients with gastrointestinal perforation with associated septic shock , 2014, Critical Care.

[13]  B. Feldman,et al.  Defining consensus: a systematic review recommends methodologic criteria for reporting of Delphi studies. , 2014, Journal of clinical epidemiology.

[14]  O. Sibony,et al.  Using and Reporting the Delphi Method for Selecting Healthcare Quality Indicators: A Systematic Review , 2011, PloS one.

[15]  A. Dignass Corrigendum to “The second European evidence-based consensus on the diagnosis and management of Crohn's disease: Current Management” [J Crohn's & Colitis 4 (2010) 28–62] , 2010 .

[16]  G. Kaplan,et al.  The Risk of Developing Crohn's Disease After an Appendectomy: A Meta-Analysis , 2008, The American Journal of Gastroenterology.

[17]  R. Caprilli,et al.  Current management of severe ulcerative colitis , 2007, Nature Clinical Practice Gastroenterology &Hepatology.

[18]  A. Forbes,et al.  Intra‐abdominal and pelvic abscess in Crohn's disease: results of non‐invasive and surgical management , 1998, The British journal of surgery.

[19]  G. Ghahremani,et al.  Appendicitis as the initial manifestation of Crohn's disease: radiologic features and prognosis. , 1987, AJR. American journal of roentgenology.

[20]  R. Gullo,et al.  Large retroperitoneal abscess extended to the inferior right limb secondary to a perforated ileal Crohn's disease: the importance of the multidisciplinary approach. , 2016, Il Giornale di chirurgia.