John C Alverdy1, Hans Martin Schardey2,3. 1. Department of Surgery, University of Chicago, Pritzker School of Medicine, 5841 S. Maryland, Chicago, IL, 60637, USA. jalverdy@surgery.bsd.uchicago.edu. 2. Department of General, Visceral, and Transplantation Surgery, Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377, Munich, Germany. 3. Department of General, Visceral and Vascular Surgery, Agatharied Hospital, Norbert-Kerkel-Platz, 83734, Hausham, Germany.
Abstract
BACKGROUND: When an anastomotic leak is discussed at a typical surgical morbidity and mortality conference, it is often presented as a due to an error in surgical technique involving ischemia, tension, or device failure. Here we assert that without direct visual analysis of the leak site and its tissue histology, an ex post facto claim that an anastomotic leak is due to an error in surgical technique remains speculative. METHODS: The arguments and rationale used to conclude that an anastomotic leak is due to an error in surgical technique are critically reviewed and assessed for their validity. RESULTS: No case series or literature exists in which a root cause analysis has been carried out with visual and tissue level evidence to determine the root cause(s) of an anastomotic leak. CONCLUSIONS: At the individual case level, declaring that an anastomotic leak is due to an error in surgical technique without clear and compelling evidence either visually and/or at the tissue level to substantiate such a claim remains speculative.
BACKGROUND: When an anastomotic leak is discussed at a typical surgical morbidity and mortality conference, it is often presented as a due to an error in surgical technique involving ischemia, tension, or device failure. Here we assert that without direct visual analysis of the leak site and its tissue histology, an ex post facto claim that an anastomotic leak is due to an error in surgical technique remains speculative. METHODS: The arguments and rationale used to conclude that an anastomotic leak is due to an error in surgical technique are critically reviewed and assessed for their validity. RESULTS: No case series or literature exists in which a root cause analysis has been carried out with visual and tissue level evidence to determine the root cause(s) of an anastomotic leak. CONCLUSIONS: At the individual case level, declaring that an anastomotic leak is due to an error in surgical technique without clear and compelling evidence either visually and/or at the tissue level to substantiate such a claim remains speculative.
Authors: M Wiegerinck; S K Hyoju; J Mao; A Zaborin; C Adriaansens; E Salzman; N H Hyman; O Zaborina; H van Goor; J C Alverdy Journal: Br J Surg Date: 2018-04-16 Impact factor: 6.939
Authors: M Hollmann; L Hellrung; B Pleger; H Schlögl; S Kabisch; M Stumvoll; A Villringer; A Horstmann Journal: Int J Obes (Lond) Date: 2011-06-28 Impact factor: 5.095
Authors: Andrea D Olivas; Benjamin D Shogan; Vesta Valuckaite; Alexander Zaborin; Natalya Belogortseva; Mark Musch; Folker Meyer; William L Trimble; Gary An; Jack Gilbert; Olga Zaborina; John C Alverdy Journal: PLoS One Date: 2012-08-31 Impact factor: 3.240