| dc.description.abstract | Background: International professional bodies have been quick to disseminate initial guidance documents during
the COVID-19 pandemic. In the absence of firm evidence, these have been developed by expert committees,
limited in participant number. This study aimed to validate international COVID-19 surgical guidance using a
rapid Delphi consensus exercise.
Methods: Delphi statements were directly mapped to guidance from surgical professional bodies in the US and
Europe (SAGES/EAES), the UK (Joint RCS), and Australasia (RACS), to validate content against international
consensus. Agreement from ≥70% participants was determined as consensus agreement.
Results: The Delphi exercise was completed by 339 individuals from 41 countries and 52 statements were
mapped to the guidance, 47 (90.4%) reaching consensus agreement. Of these, 27 statements were mapped to
SAGES/EAES guidance, 21 to the Joint RCS document, and 33 to the RACS document. Within the SAGES/EAES
document, 92.9% of items reached consensus agreement (median 89.0%, range 60.5–99.2%), 90.4% within the
Joint RCS document (87.6%, 63.4–97.9%), and 90.9% within the RACS document (85.5%, 18.7–98.8%).
Statements lacking consensus related to the surgical approach (open vs. laparoscopic), dual consultant operating,
separate instrument decontamination, and stoma formation rather than anastomosis.
Conclusion: Initial surgical COVID-19 guidance from the US, Europe and Australasia was widely supported by an
international expert community, although a small number of contentious areas emerged. These findings should
be addressed in future guidance iterations, and should stimulate urgent investigation of non-consensus areas. | |
