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Inicio Cirugía Española (English Edition) Standardization of the definition of the types of oncological colectomy. Delphi ...
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Vol. 102. Issue 9.
Pages 484-494 (September 2024)
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Vol. 102. Issue 9.
Pages 484-494 (September 2024)
Original article
Standardization of the definition of the types of oncological colectomy. Delphi method for consensus of experts of the Spanish Association of Surgeons
Estandarizacion oncologica. Metodo delphi para consenso de expertos de la asociación española de cirujanos
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Alvaro Garcia-Graneroa,b,
Corresponding author
alvaro.garciagranero@ssib.es

Corresponding author.
, Gonzalo P. Martín-Martínc,d, Paula Dujovne-Lindenbaume, Carlos J. Alvarez Lasof, Carlos Cerdán-Santacruzg, Blas Flor-Lorenteh, Sebastiano Biondoi, miembros de la Junta de la Sección Coloproctología de la AEC y colaboradores en la confección del presente estudio 1
a Unidad de Cirugía Colorrectal, Hospital Universitario Son Espases, Palma de Mallorca, Islas Baleares, Spain
b Instituto de Investigación Sanitaria Illes Balears (IdISBa), Palma de Mallorca, Islas Baleares, Spain
c Unidad Cirugía Colorrectal, Hospital Doctor Lopez Cano, Cadiz, Spain
d Unidad Cirugía Colorrectal, Hospital La Janda, Vejer de la Frontera, Cadiz, Spain
e Unidad de Cirugía Colorrectal, Hospital Universitario Gregorio Marañón, Madrid, Spain
f Unidad de Cirugía Colorrectal, Hospital Universitario de Cabueñes, Gijón, Asturias, Spain
g Unidad de Cirugía Colorrectal, Hospital Universitario de La Princesa, Madrid, Spain
h Unidad de Cirugía Colorrectal, Hospital Universitario y Politécnico la Fe, Valencia, Spain
i Unidad de Cirugía Colorrectal, Hospital Universitario Bellvitge, Barcelona, Spain
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Tables (5)
Table 1. Questions posed with respect to the right hemicolectomy, right hemicolectomy with D3 lymphadenectomy, and extended right hemicolectomy. The answers that received the most votes in the second round are presented, in addition to the right hemicolectomy. In addition, the percentage of votes in both the first and the second round are illustrated, as well as the degree of consensus.
Table 2. Questions asked about the segmental colectomy of the transverse colon and segmental colectomy of the splenic flexure. Answers receiving the most votes in the second round are displayed. In addition, the percentage of votes received in both the first and second rounds and the degree of consensus are presented.
Table 3. Questions asked about the subtotal and total colectomy. Answers receiving the most votes in the second round are displayed. In addition, the percentage of votes received in both the first and second rounds and the degree of consensus are presented.
Table 4. Questions asked about the left hemicolectomy, extended left hemicolectomy, and sigmoidectomy. Answers receiving the most votes in the second round are displayed. In addition, the percentage of votes received in both the first and second rounds and the degree of consensus are presented.
Table 5. Presents the definitive definition obtained after both rounds for each of the oncological colectomies. This definition is the results of the answers for which there was a consensus > 50%.
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Additional material (2)
Abstract

There is no international consensus on the definition of the type of oncological resection that corresponds to each of the colectomies existing in the current literature.

The objective is to define for each colectomy described in the literature: embryological dissection plane, vascular pedicles in which to perform central ligation, the extent of the colectomy, and the need for resection of the greater momentum.

A consensus of experts is carried out through the Delphi methodology through two rounds from the Coloproctology Section of the Spanish Association of Surgeons. Study period: November 2021-January 2023. 120 experts were surveyed.

Degrees of consensus: Very strong: >90%, Strong: 80%–90%, Moderate: 50%–80%, No consensus: <50%.

The definition for each oncological colectomy was established by very strong, and strong recommendations.

Each oncological colectomy was established as Right hemicolectomy (RHC), RHC with D3 lymphadenectomy, Extended-RHC, transverse colon segmental colectomy, splenic flexure segmental colectomy, subtotal colectomy, total colectomy, left hemicolectomy (LHC), extended-LHC, sigmoidectomy.

Keywords:
Standardization
Oncological colectomy
Colon cancer
Resumen

No existe consenso internacional en la definición del tipo de resección oncológica que corresponde a cada una de las colectomías existentes en la bibliografía actual.

El objetivo es definir para cada colectomía descrita en la literatura: plano de disección embriológico, pedículos vasculares en los que realizar ligadura central, la extensión de la colectomía y la necesidad de resección de epiplón mayor.

Se realiza un Consenso de expertos a través de la metodología Delphi mediante dos rondas desde la Sección Coloproctología de Asociación Española de Cirujanos. Período de estudio: noviembre 2021-enero 2023. Fueron encuestados 120 expertos.

Grados de consenso: Muy fuerte: >90%, Fuerte: 80%–90%, Moderado: 50%–80%, No consenso: <50%.

La definición para cada colectomía oncológica quedó establecida mediante recomendaciones muy fuertes y fuertes.

Colectomías definidas: hemicolectomía derecha (HCD), HCD con linfadenectomía D3, HCD-ampliada, colectomía segmentaria de colon transverso, resección segmentaria ángulo esplénico, colectomía subtotal, total, hemicolectomía izquierda (HCI), HCI-ampliada y sigmoidectomía.

Palabras clave:
Estandarización Colectomía oncológica
Cirugía cáncer de colon

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