title: Predictors of intra- and postoperative complications in laparoscopic colorectal surgery: results of an expert survey.
abstract: BACKGROUND
  The decision which patient should undergo laparoscopic rather than open colorectal surgery depends on weighing its benefits against its complications. We explored which criteria prognosticate complications in a laparoscopic intervention by assembling experienced visceral surgeons' beliefs.
  
  
  METHODS
  A two-round postal survey was conducted: 21 experts in laparoscopic surgery were contacted and asked to list (first round) and weigh (second round) indicators (scale 1-10) they believed predicted intra- or postoperative complications in patients undergoing laparoscopic colorectal surgery. Median ratings and interquartile ranges (IQRs) were calculated. Rates >or=6 and IQRs <or=3 depicted an important prognostic indicator for complications.
  
  
  RESULTS
  Thirty-nine intraoperative and 43 postoperative listings and ratings of 19 experts (90%) were available for analysis. The experts depicted three domains of indicators (tumor, comorbidity and related institution). The strongest indicators for intraoperative complications were surgeon's experience (median 9, IQR 8-10) and portal hypertension (median 9, IQR 7-10), and those for postoperative complications were liver cirrhosis Child B/C (median 8, IQR 7.75-10) and experience of the surgeon (median 8, IQR 7-10).
  
  
  CONCLUSIONS
  This survey provides additional evidence of risk indicators for intra- and postoperative complications in patients undergoing laparoscopic colorectal surgery. Whether the identified indicators can be compiled into a prognostic instrument requires confirmation in a properly designed and sized study.
authors.affiliation: Horten Centre for Patient-Oriented Research, University Hospital of Zurich, Zurich, Switzerland.
authors.forename: Selim
authors.initials: S
authors.lastname: Dincler
authors.forename: Lucas M
authors.initials: LM
authors.lastname: Bachmann
authors.forename: Peter
authors.initials: P
authors.lastname: Buchmann
authors.forename: Johann
authors.initials: J
authors.lastname: Steurer
mesh_terms: D003106:Colon / Q000601:surgery*; D003107:Colorectal Surgery; D003625:Data Collection; D006801:Humans; D007431:Intraoperative Complications; D010535:Laparoscopy; D011183:Postoperative Complications; D012007:Rectum / Q000601:surgery*; D012307:Risk Factors