Project Eagle

EAGLE: ESCP Safe-anastomosis Programme in Colorectal Surgery.

Access the EAGLE educational platform free at https://eagle-escp.eu.com/

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PATIENTS RECRUITED

Background

The ESCP Safe-anastomosis Programme in Colorectal Surgery (EAGLE) is an international, cluster randomised-sequence study of a Safe-anastomosis Quality Improvement Intervention to reduce anastomotic leak following right colectomy and ileocaecal resection.

Anastomotic leak is a severe, potentially life-threatening complication following right colectomy. Internationally, anastomotic leak occurs after 8% of right colectomies. Prospective cohort data demonstrate that patient selection, intraoperative factors, and technical variation are risk factors for anastomotic leak.

The Eagle trial is the latest and most ambitious of the global ‘snap shot studies’ that the European Society of Coloproctology (ESCP) has run over the past five years. The study consists of interactive, online training modules for surgeons and theatre teams and will assess whether implementation of the ESCP Safe-anastomosis intervention reduces risk of anastomotic leak rate.

Overall, we are aiming to collaborate with more than 2,000 surgeons in over 300 hospitals across the world, including 4,500 patients in total.

You can find out more about EAGLE, including how to get involved at  https://is.gd/EAGLEsitesetup

Aims & Objectives

Primary Objectives

  • Preoperative risk stratification – making sure for each patient that anastomosis is safe for them.
  • Harmonisation of surgical technique – making the best anastomosis possible and checking it carefully after it is created.
  • Implementation of an intra-operative anastomosis checklist – focusing the attention of the whole theatre team at this critical stage of the operation.

Anastomotic leak is a severe, potentially life-threatening complication following right colectomy. Internationally, anastomotic leak occurs after 8% of right colectomies. Prospective cohort data demonstrate that patient selection, intraoperative factors, and technical variation are risk factors for anastomotic leak

To assess whether implementation of the ESCP Safe-anastomosis intervention reduces risk of anastomotic leak rate.

International, multi-centre, cluster randomised-sequence service improvement study, with the hospital as the cluster. Phased Dog-leg schedule for repeated assessments with 3 randomisation sequences. Meta-analysis of results will be performed from individual dog legs (indicatively four dog legs).

Any hospital or surgical unit performing elective and/or emergency colorectal surgery. Adults (age 18 years and above) undergoing right colectomy or ileocaecal resection for any indication are eligible, including elective, expedited or emergency surgery by open, laparoscopic or robotic approaches.

30-day overall anastomotic leak rate, defined as clinical or radiologically detected anastomotic leak or intra-abdominal or pelvic collection.