Imperial College London
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Mr Christos Kontovounisios

Faculty of Medicine, Department of Surgery & Cancer

Visiting Reader
 
 
 
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Contact

 

+44 (0)20 3315 8529c.kontovounisios

 
 
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Location

 

Chelsea and Westminster HospitalChelsea and Westminster Campus

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Summary

 

Publications

Citation

BibTex format

@article{Kontovounisios:2021:bjsopen/zrab082,
author = {Kontovounisios, C},
doi = {bjsopen/zrab082},
journal = {BJS Open},
pages = {1--7},
title = {Perioperative optimization in complex abdominal wall hernias: Delphi consensus statement},
url = {http://dx.doi.org/10.1093/bjsopen/zrab082},
volume = {5},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background The incidence of incisional hernia after major abdominal surgery via a midline laparotomy is 20–41 percent with short-term follow-up, and over 50 per cent in those surviving an abdominal catastrophe.Abdominal wall reconstruction (AWR) requires complex operations, often involving mesh resection,management of scarred skin, fistula takedown, component separation or flap reconstruction. Patientstend to have more complex conditions, with multiple co-morbidities predisposing them to a viciouscycle of complications and, subsequently, hernia recurrence. Currently there appears to be variance inperioperative practice and minimal guidance globally. The aim of this Delphi consensus was to providea clear benchmark of care for the preoperative assessment and perioperative optimization of patientsundergoing AWR.MethodsThe Delphi method was used to achieve consensus from invited experts in the field of AWR. Thirtytwo hernia surgeons from recognized hernia societies globally took part. The process included tworounds of anonymous web-based voting with response analysis and formal feedback, concluding witha live round of voting followed by discussion at an international conference. Consensus for a strongrecommendation was achieved with 80 per cent agreement, and a weak recommendation with 75 percent agreement.  ResultsConsensus was obtained on 52 statements including surgical assessment, preoperative assessment,perioperative optimization, multidisciplinary team and decision-making, and quality-of-life assessment.Forty-six achieved over 80 per cent agreement; 14 statements achieved over 95 per cent agreement.ConclusionClear consensus recommendations from a global group of experts in the AWR field are presented inthis study. These should be used as a baseline for surgeons and centres managing abdominal wallhernias and performing complex AWR.TOC summary: The Delphi method was used to provide consensus statements for preoperativeassessment and perioperative optimization
AU  - Kontovounisios,C
DO  - bjsopen/zrab082
EP  - 7
PY  - 2021///
SN  - 2474-9842
SP  - 1
TI  - Perioperative optimization in complex abdominal wall hernias: Delphi consensus statement
T2  - BJS Open
UR  - http://dx.doi.org/10.1093/bjsopen/zrab082
UR  - https://academic.oup.com/bjsopen/article/5/5/zrab082/6375607
UR  - http://hdl.handle.net/10044/1/91517
VL  - 5
ER  -
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