EAGLE Study Launch at the European Society of Coloproctology Annual Meeting, Vienna September 2019  

A team of surgeons and researchers from the NIHR Global Health Research Unit on Global Surgery, in partnership with the European Society of Coloproctology (ESCP) Cohort Studies & Audit Committee, were delighted to present the upcoming EAGLE study to a packed audience of 200 colorectal surgeons in the Austria Centre, Vienna.

The 2015 ESCP audit of right colectomy and ileocaecal resection identified that 8.1% of patients suffered an anastomotic leak or intraabdominal question, and this risk was higher with a stapled versus handsewn anastomosis after risk adjustment. In response, Professor Dion Morton made the ‘Hamburg declaration’ in 2017 proposing that the ESCP global community of colorectal surgeons prioritise risk reduction in anastomotic leak for the benefit of patients.

The audience at the 2019 Annual Meeting heard how the ESCP Safe-anastomosis intervention had grown from this declaration and three common principles for anastomotic leak risk reduction were discussed:

  • Routine risk stratification for patients undergoing right colectomy
  • An intraoperative ESCP Safe-anastomosis Checklist to support in-theatre decision making
  • Harmonising technique for handsewn and stapled anastomoses

EAGLE is an international study evaluating the effectiveness of this intervention. It will use a novel design which is simple for the surgeon and research team to run, minimises the number of patients required in the study to achieve a well powered result, and means that every theatre team have chance to benefit from the Safe-anastomosis intervention.

It will use a cluster-randomised design, where the randomisation allocation decides when the quality improvement intervention is received.

The longest period data will need to be collected at any site is 5 months (2 months before implementation, 1 month of implementation, 2 months post implementation), with 2/3 sites having data for 3 months only (approximately 10-15 patients based on the 2015 audit).

Questions at the Vienna launch focused on how centre level ethics would be obtained (rather than patient level) and the audience feedback reflected how excited the colorectal community was to lead the most ambitious international collaborative research study to date!

If you are a surgeon that performs right colectomy or ileocaecal resection and are interested to learn more, or to get involved in EAGLE, please visit https://is.gd/EAGLEsitesetup

As of 10th October 2019, over 198 hospitals from 44 countries around the world had already registered to participate in EAGLE. An international team of 22 coordinators is ready to help support hospitals in setting up their sites for EAGLE!

We look forward to collaborating with you as the global colorectal surgery community!