Italian survey about intraperitoneal drain use in distal pancreatectomy
Rattachement africain : it, cn. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Intraperitoneal prophylactic drain (IPD) use in distal pancreatectomy (DP) is still controversial. A survey was carried out through the Italian community of pancreatic surgeons using institutional emails, Twitter, and Facebook accounts of the Italian Association for the Study of the Pancreas (AISP) and the Italian Association of Hepato-biliary-pancreatic Surgery (AICEP). The survey was structured to learn surgeons' practice in using IPD through questions and one clinical vignette. Respondents were asked to report their regrets for omission and commission regarding the IPD use for the clinical scenario, eliciting a scale between 0 (no regret) and 100 (maximum regret). The threshold model and a multilevel mixed regression were built to identify respondents' attitudes. One hundred six surgeons completed the survey. Sixty-three (59.4%) respondents confirmed using at least 1 drain, while 43 (40.6%) placed 2 IPDs. Only 13 respondents (12.3%) declared a change in IPD strategy in patients at high risk of clinically relevant postoperative pancreatic fistula (CR-POPF), while 9 (9.4%) respondents changed their strategy in low-risk POPF situations. Thirty-five (35.5%) respondents declared they would remove the IPD within the third postoperative day (POD) in the absence of CR-POPF suspicion. The median omission regret, which proved to be the wrong decision, was 80 (50-100, IQR). The median regret due to the commission of IPD, which turned out to be useless, was 2.5 (1-20, IQR). The CR-POPF probability threshold at which drainage omission was the less regrettable choice was 7% (1-35, IQR). The threshold to perceive drain omission as the least regrettable choice was higher in female surgeons (P < 0.001), in surgeons who modulated the strategies based on the risk of CR-POPF, and in high volume centers (p = 0.039). The threshold was lower in surgeons who performed minimally invasive distal pancreatectomy (P < 0.001), adopted a closed system (P < 0.001), placed two IPDs (P < 0.001), or perceived the IPD as important to prevent reintervention (p = 0.047). Drain management after DP remains very heterogeneous among surgeons. The regret model suggested that IPD omission could be performed in low-risk patients (7% of CR-POPF), leading to low regret in the case of the wrong decision, making it an acceptable clinical decision.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Italian survey about intraperitoneal drain use in distal pancreatectomy
- Date Crossref
- 13/10/2024
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Vita-Salute San Raffaele University pays non établi dans la noticeUniversité ou école supérieure
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University of Bologna Department of Internal Medicine and Surgery (DIMEC) pays non établi dans la noticeUniversité ou école supérieure
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University of Verona General and Pancreatic Surgery Department pays non établi dans la noticeUniversité ou école supérieure
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Humanitas University Department of Biomedical Sciences pays non établi dans la noticeUniversité ou école supérieure
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Istituti di Ricovero e Cura a Carattere Scientifico pays non établi dans la noticeÉtablissement de santé
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Casa di Cura Villa Garda pays non établi dans la noticeÉtablissement de santé
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University of Pisa Division of General and Transplant Surgery pays non établi dans la noticeUniversité ou école supérieure
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Ospedale G.B. Morgagni - L.Pierantoni pays non établi dans la noticeÉtablissement de santé
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Beijing Drainage Group (China) pays non établi dans la noticeEntreprise
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Pancreas Translational and Clinical Research Center Pancreatic Surgery Unit pays non établi dans la noticeStructure de recherche
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Vita-Salute" San Raffaele University pays non établi dans la noticeUniversité ou école supérieure
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Humanitas Clinical and Research Center-IRCCS Pancreatic Surgery Unit pays non établi dans la noticeStructure de recherche
Vita-Salute San Raffaele University, Department of Internal Medicine and Surgery (DIMEC) — University of Bologna et General and Pancreatic Surgery Department — University of Verona, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.