Association of Upper Gastrointestinal Surgery of Great Britain and Ireland (AUGIS)/Perioperative Quality Initiative (POQI) consensus statement on intraoperative and postoperative interventions to reduce pulmonary complications after oesophagectomy
Association of Upper Gastrointestinal Surgery of Great Britain and Ireland (AUGIS)/Perioperative Quality Initiative (POQI) consensus statement on intraoperative and postoperative interventions to reduce pulmonary complications after oesophagectomy
BACKGROUND: Pulmonary complications are the most common morbidity after oesophagectomy, contributing to mortality and prolonged postoperative recovery, and have a negative impact on health-related quality of life. A variety of single or bundled interventions in the perioperative setting have been developed to reduce the incidence of pulmonary complications. Significant variation in practice exists across the UK. The aim of this modified Delphi consensus was to deliver clear evidence-based consensus recommendations regarding intraoperative and postoperative care that may reduce pulmonary complications after oesophagectomy.
METHODS: With input from a multidisciplinary group of 23 experts in the perioperative management of patients undergoing surgery for oesophageal cancer, a modified Delphi method was employed. Following an initial systematic review of relevant literature, a range of anaesthetic, surgical, and postoperative care interventions were identified. These were then discussed during a two-part virtual conference. Recommendation statements were drafted, refined, and agreed by all attendees. The level of evidence supporting each statement was considered.
RESULTS: Consensus was reached on 12 statements on topics including operative approach, pyloric drainage strategies, intraoperative fluid and ventilation strategies, perioperative analgesia, postoperative feeding plans, and physiotherapy interventions. Seven additional questions concerning the perioperative management of patients undergoing oesophagectomy were highlighted to guide future research.
CONCLUSION: Clear consensus recommendations regarding intraoperative and postoperative interventions that may reduce pulmonary complications after oesophagectomy are presented.
1096-1106
Singh, Pritam
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Gossage, James
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Markar, Sheraz
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Pucher, Philip H
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Wickham, Alex
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Weblin, Jonathan
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Chidambaram, Swathikan
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Bull, Alexander
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Pickering, Oliver
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Mythen, Monty
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Maynard, Nick
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Grocott, Mike
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Underwood, Tim
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Levett, Denny
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West, Malcolm
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Noble, Fergus
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AUGIS/POQI Pulmonary Consensus Group
24 August 2022
Singh, Pritam
b3816602-3432-4b1a-b332-c62e9fac55a4
Gossage, James
17d9224b-b967-45af-9a09-6a113b53fb69
Markar, Sheraz
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Pucher, Philip H
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Wickham, Alex
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Weblin, Jonathan
ae162134-eac7-49b4-95f1-0c4fd35deede
Chidambaram, Swathikan
5c38d8bb-244a-49b9-8c6b-b9d5ea46aa4c
Bull, Alexander
843df257-a845-4e0c-b656-36ea942ad601
Pickering, Oliver
ffdcc1fa-9cb4-4ff0-8fdf-d97445ed7b44
Mythen, Monty
ced4210c-1c97-4e00-aa51-58dea2959848
Maynard, Nick
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Grocott, Mike
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Underwood, Tim
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Levett, Denny
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West, Malcolm
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Noble, Fergus
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Singh, Pritam, Gossage, James, Markar, Sheraz, Pucher, Philip H, Wickham, Alex, Weblin, Jonathan, Chidambaram, Swathikan, Bull, Alexander, Pickering, Oliver, Mythen, Monty, Maynard, Nick, Grocott, Mike and Underwood, Tim
,
AUGIS/POQI Pulmonary Consensus Group
(2022)
Association of Upper Gastrointestinal Surgery of Great Britain and Ireland (AUGIS)/Perioperative Quality Initiative (POQI) consensus statement on intraoperative and postoperative interventions to reduce pulmonary complications after oesophagectomy.
British Journal of Surgery, 109 (11), , [194].
(doi:10.1093/bjs/znac193).
Abstract
BACKGROUND: Pulmonary complications are the most common morbidity after oesophagectomy, contributing to mortality and prolonged postoperative recovery, and have a negative impact on health-related quality of life. A variety of single or bundled interventions in the perioperative setting have been developed to reduce the incidence of pulmonary complications. Significant variation in practice exists across the UK. The aim of this modified Delphi consensus was to deliver clear evidence-based consensus recommendations regarding intraoperative and postoperative care that may reduce pulmonary complications after oesophagectomy.
METHODS: With input from a multidisciplinary group of 23 experts in the perioperative management of patients undergoing surgery for oesophageal cancer, a modified Delphi method was employed. Following an initial systematic review of relevant literature, a range of anaesthetic, surgical, and postoperative care interventions were identified. These were then discussed during a two-part virtual conference. Recommendation statements were drafted, refined, and agreed by all attendees. The level of evidence supporting each statement was considered.
RESULTS: Consensus was reached on 12 statements on topics including operative approach, pyloric drainage strategies, intraoperative fluid and ventilation strategies, perioperative analgesia, postoperative feeding plans, and physiotherapy interventions. Seven additional questions concerning the perioperative management of patients undergoing oesophagectomy were highlighted to guide future research.
CONCLUSION: Clear consensus recommendations regarding intraoperative and postoperative interventions that may reduce pulmonary complications after oesophagectomy are presented.
Text
znac193 (1)
- Version of Record
More information
Accepted/In Press date: 9 May 2022
e-pub ahead of print date: 24 August 2022
Published date: 24 August 2022
Additional Information:
Funding: Supported by Heartburn Cancer UK and AUGIS
M.G. receives part of his funding through the National Institute for Health Research (NIHR) Senior Investigator Scheme and part through the NIHR Southampton Biomedical Research Centre.
Identifiers
Local EPrints ID: 470277
URI: http://eprints.soton.ac.uk/id/eprint/470277
ISSN: 0007-1323
PURE UUID: 9aece317-4bbd-4462-afbc-ff782c0a34a6
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Date deposited: 05 Oct 2022 16:43
Last modified: 06 Jun 2024 01:59
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Contributors
Author:
Pritam Singh
Author:
James Gossage
Author:
Sheraz Markar
Author:
Philip H Pucher
Author:
Alex Wickham
Author:
Jonathan Weblin
Author:
Swathikan Chidambaram
Author:
Alexander Bull
Author:
Oliver Pickering
Author:
Monty Mythen
Author:
Nick Maynard
Author:
Denny Levett
Author:
Fergus Noble
Corporate Author: AUGIS/POQI Pulmonary Consensus Group
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