Danique Heuvelings

206 ABSTRACT Background. Anastomotic leakage is a well-known complication following colorectal surgery, however, there is limited knowledge about patients live their experiences with leaks across the care continuum, from initial diagnosis and treatment to long-term recovery. Objective. To explore patients’ experiences and perspectives related to an anastomotic leak after colorectal resection, to inform the ‘Consensus on Reporting and defining colorectal Anastomotic Leaks (CoReAL)’ project Design. Qualitative descriptive study reported using the COnsolidated criteria for REporting Qualitative research (COREQ). Settings. Online semi-structured interviews conducted with patients from five countries (Australia, Canada, Netherlands, United Kingdom, and United States). Participants. Ten participants (six male, median age 53 [range 39 –65 years]) who experienced an anastomotic leak following a colorectal resection. Main Outcome Measures. Themes emerging from thematic analysis until saturation was reached. Results. Four main themes were identified: (1) physical impact, (2) emotional impact, (3) coping mechanisms, and (4) anastomotic leak care. Within these themes, participants detailed their lived experience during the different phases of the care continuum: diagnosis, treatment, early and late recovery. Additionally, participants indicated the elements of anastomotic leak care that they deemed most important, including preoperative education, communication, support from medical staff and peers, sharing of information, aftercare, shared decision making, and case management. Conclusions. Patients having experienced a colorectal anastomotic leak reported a physical and emotional impact, applied different coping strategies, and emphasized the importance of clear communication, comprehensive care, and sustained attention beyond the early postoperative and treatment phase. Keywords. Anastomotic leakage, qualitative study, participant reported outcomes, colorectal surgery, Burden of disease, semi-structured interviews.

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