Definition of colorectal anastomotic leakage: A consensus survey among Dutch and Chinese colorectal surgeons

Table 1 English questionnaire on definition of colorectal anastomotic leakage

General definition
Do we have to consider the following findings as anastomotic leakage?			Yes	No
1	Extravasation of contrast after rectal enema on a CT scan
2	Radiological collection around the anastomosis and no treatment
3	Radiological collection around the anastomosis treated with antibiotics
4	Radiological collection around the anastomosis treated with percutaneous drainage
5	Abdominal sepsis and reoperation needed
6	Necrosis of the anastomosis seen at reoperation
7	Necrosis of the blind loop seen at reoperation
8	Signs of peritonitis during reoperation
9	Air bubbles around the anastomosis seen on a CT scan
10	Free intra-abdominal air seen on a CT scan
Clinical diagnosis
In what extent do the following clinical parameters contribute to the suspicion of colorectal anastomotic leakage? Please note the relevance on a numeric scale of 0-10:
1	Increased C-reactive protein
2	Increased leukocytes
3	Tachycardia
4	Increased respiratory rate
5	(Sub-) febrile temperature
6	Postoperative ileus (> 4 d)
7	Deterioration in clinical condition
8	Abdominal pain, other than wound pain
Radiological diagnosis
Answer the following questions using percentages (0% = never, 100% = always)
1	In how many percent of patients with clinical suspicion of anastomotic leakage do you perform radiodiagnostics?
2	In how many percent of patients with clinical suspicion of anastomotic leakage do radiodiagnostics change your treatment policy?
3	In how many cases did the CT scan report no anastomotic leakage while there finally was an anastomotic leakage.
4	In how many percent of cases do you consider a reoperation without previous radiodiagnostics?
Early anastomotic leakage
In your opinion, is ‘very early (< 3 d) anastomotic leakage the result of technical failure?
1	Yes
2	No