5640 operations from 49 countries included in ESCP research initial findings reveal average leak rate across all techniques as 8.6%
The European Society of Coloproctologists (ESCP) has revealed that almost 1500 clinicians from around the world (49 countries) have participated in its latest cohort study recording and sharing the results of 5640 operations – marking one of the largest studies of its kind.
The multi-site study collected data on patients undergoing left colon, sigmoid and rectal resection operations internationally to identify whether surgical technique impacts on postoperative outcomes. It explores areas of practice variability resulting in apparent differences in outcome which warrant further study. All operations for any pathology, via any operative approach were included in the snap-shot study which was completed earlier this year.
The operative patient outcomes measured after 30 days included, anastomotic leak, intra-abdominal abscess, complication (Clavien-Dindo) and re-operation rates. While the first conclusions of the ESCP 2017 Cohort study are not expected until Spring next year, initial analysis reveals that the average leak rate across all techniques is higher than previously perceived – at 8.6%.
Dion Morton, Chair of the ESCP Research Committee said:
We are very excited about the level of response to this cohort study. Collecting results from so many operations internationally is unprecedented.
This pioneering research model provides a superb opportunity to generate large datasets on surgical interventions and their outcomes without many of the hurdles of performing a randomized controlled trial (RCT), and at a fraction of the cost and time investment. The fact that we’ve already uncovered an insight which confronts accepted perceptions of average leak rates after surgery underlines the potential for further insights once full analysis is undertaken.
There is a particular need for surgeons to engage in high quality prospective studies of this type to bridge the current gulf between a paucity of RCTs and the over-abundance of level IV evidence derived from personal case series and poor quality cohort studies.
This study is the third in the ESCP’s series of studies on bowel anastomoses. ESCP’s first cohort study on right hemicolectomy was completed in 2015 across 284 centers, including 3200 patients. The second study, in 2016, focused on stoma closures across 305 centers, including 2441 patients. The results from the previous two cohorts are already paving the way for progress on treatments.