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Peer review report 1 on “Risk factors for reoperation after ileostomy reversal - Results from a prospective cohort study”
International Journal of Surgery 37 Supplement 1 (2017) S20
Contents lists available at ScienceDirect
International Journal of Surgery journal homepage: www.journal-surgery.net
Peer review report
Peer review report 1 on “Risk factors for reoperation after ileostomy reversal - Results from a prospective cohort study”
1. Original submission 1.1. Recommendation Major revision. 1.2. Comments to the author There are many well known factors which might be associated with higher anastomotic leakage rate following any gut resection. Many would concor that malnutrition (assessed in terms of anemia and low albumin level), patient ASA level and above all anastomotic technique/ experienece are the most important factors in determining the fate of an anastomosis. This is a low powered study with relatively smaller sample size and mixed conclusions. I would suggest the authors to assess the albumin level and anemia both as a risk factor for anastomotic failure. I would also like to see the rate of failure in terms of surgeon experienece too with a bit higher sample size. I beleive that adhesionlysis performed by an
DOI of published article: http://dx.doi.org/10.1016/j.ijsu.2016.10.043. http://dx.doi.org/10.1016/j.ijsu.2016.12.001 1743-9191
experienced surgeons has low risk of iatrogenic perforation, serosal tears and morbidity. I once asked my mentor about three causes of anastomotic disruption and he said, “boy this is your technique, your technique and your technique”. I would be interested in seeing the leakage rate once these patients have been optimized in terms of anemia. Overall this is an acceptable clinical study but has room for improvement. 2. First revision 2.1. Recommendation Accept Anonymous reviewer
Contents lists available at ScienceDirect
International Journal of Surgery journal homepage: www.journal-surgery.net
Peer review report
Peer review report 1 on “Risk factors for reoperation after ileostomy reversal - Results from a prospective cohort study”
1. Original submission 1.1. Recommendation Major revision. 1.2. Comments to the author There are many well known factors which might be associated with higher anastomotic leakage rate following any gut resection. Many would concor that malnutrition (assessed in terms of anemia and low albumin level), patient ASA level and above all anastomotic technique/ experienece are the most important factors in determining the fate of an anastomosis. This is a low powered study with relatively smaller sample size and mixed conclusions. I would suggest the authors to assess the albumin level and anemia both as a risk factor for anastomotic failure. I would also like to see the rate of failure in terms of surgeon experienece too with a bit higher sample size. I beleive that adhesionlysis performed by an
DOI of published article: http://dx.doi.org/10.1016/j.ijsu.2016.10.043. http://dx.doi.org/10.1016/j.ijsu.2016.12.001 1743-9191
experienced surgeons has low risk of iatrogenic perforation, serosal tears and morbidity. I once asked my mentor about three causes of anastomotic disruption and he said, “boy this is your technique, your technique and your technique”. I would be interested in seeing the leakage rate once these patients have been optimized in terms of anemia. Overall this is an acceptable clinical study but has room for improvement. 2. First revision 2.1. Recommendation Accept Anonymous reviewer