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International standardization and optimization group for intersphincteric resection (ISOG-ISR): modified Delphi
Guglielmo Niccolò Piozzi1, Krunal Khobragade2, Vusal Aliyev3
1Korea University Anam Hospital, Seoul, Korea.
Summary
Standardizing Intersphincteric Resection (ISR) for rectal cancer is crucial. This study achieved international expert consensus on ISR definitions, indications, and techniques for better research comparison.
Area of Science:
- Colorectal Surgery
- Surgical Oncology
- Gastrointestinal Oncology
Background:
- Intersphincteric resection (ISR) is a complex surgical procedure for very low-lying rectal cancers.
- Current definitions, indications, and techniques for ISR lack standardization, hindering comparative research.
Purpose of the Study:
- To establish an international expert consensus on the definition and standardization of Intersphincteric Resection (ISR).
- To enable precise surgical descriptions and facilitate meaningful comparisons in future literature.
Main Methods:
- A modified Delphi approach involving three rounds of questionnaires was used.
- Twenty-nine international experts from 11 countries participated, addressing six domains and 37 statements.
Main Results:
- Consensus (≥80% agreement) was reached on 36 out of 37 statements after three rounds of questionnaires.
- Standardized definitions for intersphincteric dissection, ISR, and ultra-low anterior resection (uLAR) were established.
Conclusions:
- This study presents the first international expert consensus-based definition and standardization of ISR.
- Key outcomes include defined indications for ISR based on tumor infiltration, a new definition for T3isp tumors, and standardized surgical techniques and outcome assessment.
