207 The patient perspective on colorectal anastomotic leaks: A qualitative study INTRODUCTION Anastomotic leakage (AL) is one of the most dreaded complications following colorectal resection. The severity of AL varies based on its management, ranging from small defects, which may be managed conservatively with antibiotics and drainage of potential abscesses, to major dehiscence leading to peritonitis and sepsis, requiring reoperation, intensive care unit (ICU) admission, prolonged hospitalization and even death 1, 2. Moreover, AL often leads to delays in adjuvant therapy and stoma reversal, which negatively impacts oncological, functional and quality of life (QoL) outcomes 3-6. Despite the extensive evidence on the prevalence, etiology, risk factors, treatment algorithms, and outcomes of colorectal AL, patients’ experiences with this complication have not been fully explored in qualitative studies. This approach is essential for capturing the complexities of patients’ perspectives, which quantitative methods cannot fully address 7, in the co-design of effective surgical care pathways 8. Understanding patients’ perspectives and experiences throughout this complication will provide insight into optimizing AL care. This includes managing expectations, communicating the diagnosis, deciding on a treatment plan, ensuring patients understand the anticipated outcomes, and providing multidisciplinary support for patients and their families throughout the entire care continuum 3, 9. The aim of this qualitative study was to explore patients’ experiences and perspectives with the diagnosis, treatment, and recovery from a colorectal AL. This preliminary study was conducted with patient partners from the ‘Consensus on Reporting and defining colorectal Anastomotic Leaks (CoReAL)’ project, an American Society of Colon and Rectal Surgeons (ASCRS) initiative to create a standardized framework for AL reporting after colorectal cancer surgery and served as an informative step for the framework. METHODS Study design This was a qualitative study using semi-structured interviews conducted online from AugustSeptember 2023 10. This inductive methodology resulted in independence from pre-existing theoretical or philosophical commitments, aligning with our primary aim of describing patients’ experiences 11, 12. This study was reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist 13, 14. Participants and recruitment Members of the CoReAL collaborative identified eligible patient partners from surgical societies, individual institutions or patient organizations. Adult patients (≥ 18 years old) who had experienced an AL following a colorectal resection for benign or malignant indications, 10
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