3 research outputs found
Stoma-free Survival After Rectal Cancer Resection With Anastomotic Leakage: Development and Validation of a Prediction Model in a Large International Cohort.
- Author
- Abbas Ayman
- Abbood Ali Hashim
- Abdeen Basel
- Abdelaal Ahmed Samir
- Abdullah Nik A N
- Abdulwahed Eman
- Abelevich Alexander
- Abu Elnga Ahmed Nagm Eldin
- Abujamra Saleh
- Acar Nihan CoĆgun
- Afzal Asma
- Agalianos Christos
- Agapov Mikhail N
- Agostinelli Laura
- Ahmed Safia
- Aigner Felix
- Akyol Cihangir
- Al-Eryani Fatima
- Al-Juaifari Maytham A
- Al-Najami Issam
- Alanez-Saavedra Javier
- Albakry Rudaina
- Alcåzar Montero José A
- Alhardan Anas
- Alhisi Ahmed Jehad
- Ali Ahmed K
- Alkady Eithar
- Allmer Caterina
- Alonso Alfredo
- Alrayes Bourhan M H
- Alshareea Entisar
- Altomare Donato F
- Altrabulsi Amani
- Alvarez-Bautista Francisco E
- Amano Takahiro
- Amelung Femke J
- Anderin Kajsa
- Annicchiarico Alfredo
- Ansorena Yolanda Saralegui
- Antona Francisco Blanco
- Antonopoulou Maria-Ioanna
- Aprile Alessandra
- Armao Francesca T
- Arroyo Antonio
- Ashmore Daniel
- Atak Ä°brahim
- Atanasov Boyko
- Atici Semra Demirli
- Atienza Paula GonzĂĄlez
- Avanagh Dara O
- Avellaneda Nicolas
- Aversano Alessia
- Aydın Oguzhan
- Ayoub Kusay
- Azevedo Constança
- Baatrup Gunnar
- Baban Bayar
- Badiani Sarit
- Baili Efstratia
- Balalis Dimitrios
- Balci Bengi
- Balık Emre
- Ballabio Michele
- Baloyiannis Ioannis
- Barbero-Valenzuela Alejandro
- Bassyouni Ashoush Fouad M
- Bavikatte Akshay
- Bazaev Andrey
- Belev Nikolay
- Bellato Vittoria
- BeltrĂĄn de Heredia Juan P
- Belvedere Angela
- Benkabbou Amine
- BenÄurik Vladimir
- Bernal-Sprekelsen Juan C
- Berney Christophe
- Bethune Rob M
- Bhandari Santosh
- Bhat Sameer
- Binder Alf-Dorian
- Biondi Alberto
- Bisagni Pietro
- Bislenghi Gabriele
- Bissett Ian
- BiĆgin TAYFUN
- BjĂžrsum-Meyer Thomas
- Blas Juan L
- Bloemen Johanne G
- Boerma Evert-Jan G
- Bonito Alba Correa
- Borda Francisco Javier GarcĂa
- Borda-Arrizabalaga Nerea
- Bottazzoli Elisa I
- Boutall Adam
- Bouvy Nicole D
- BoĆŸiÄ Tajda KoĆĄir
- Brachini Gioia
- Bradley Nicholas
- Bremers Andreas J A
- Buchs Nicolas
- Buchwald Pamela
- Bulut Mehmet TĂŒrker
- Burger Jacobus W A
- Burghgraef Thijs A
- Busund Sondre
- Buzzi Gianluca
- BuÄra Dursun
- CalabrĂČ Marcello
- Calero-Lillo ArĂĄnzazu
- Calik Bulent
- Carbone Fabio
- Carreño-Villarreal Guillermo
- Carrie Augusto
- Carvello Michele
- Carvello Michele
- Catena Fausto
- Cengiz Fevzi
- Cerbo Daniele
- Ceretti Andrea P
- Chandio Ashfaq
- Chaoui Ahmed
- Charalabopoulos Alexandros
- Chaudhri Sanjay
- Chautems Roland
- Chawla Tabish
- Chawla Tabish
- Cholewa Hannia
- Christodoulidis Grigorios
- Chrysos Emmanuel
- CiftciEngin Aybar Ahmet B
- Cifuentes-Ródenas José A
- Cirillo Bruno
- Ciubotaru Cezar
- Ciubotaru Cezar
- Clerici Federico
- Coco Claudio
- Coetzee Emile
- Colak Elif
- Collard Maxime K
- Colucci Nicola
- ColĂĄs-Ruiz Enrique
- Connelly Tara M
- Consten Esther C J
- Consten Esther C J
- Corbellini Carlo
- Cotte Eddy
- Creemers Davy M J
- Crescentini Giacomo
- D'Agostino Luca
- D'Alimonte Lucrezia
- D'Hoore André
- da Costa Devesa Helena M
- da Silva Nigel
- Daester Silvio
- Darias IvĂĄn Soto
- Darlin Lotten
- Darwich Haitham
- Dattani Mit
- de Andrés Beatriz
- de Gheldere Charles
- de Graaf Eelco J R
- de Groot-van Veen Irene
- de Haan Jael
- de La Cruz Cuadrado Cristina
- de Lacy Francisco B
- de Manzoni Giovanni
- de Nes Lindsey C F
- de Paola Gilda
- de Pasqual Carlo A
- de Simone Belinda D
- de Vriendt Stefanie
- de Wilt Johannes H W
- Deeknah Abdulqudus
- Defoort Barbara
- deGiuli Maurizio
- Dekker Jan-Willem T
- Del Hoyo Aretxabala Izaskun
- Delrio Paolo
- Demirkiran Ahmet
- den Boer Frank
- Denost Quentin
- Dewulf Maxime
- deĂngelis Nicola
- di Cosmo Maria A
- Di Saverio Salomone
- Dimofte Gabriel-Mihail
- Dinaux Anne M
- Dittrich Luca S
- Diéguez Beatriz
- Docampo Iria Losada
- Dogan LĂŒtfi
- Doornebosch Pascal G
- Drozdov EvgeniyS
- Dudi-Venkata Nagendra N
- Dursun Ayberk
- Dziakova Jana
- DĂŒzgĂŒn ĂzgĂŒl
- Echaniz Garazi Elorza
- Echiguer Sabrillah
- Eduard Galliamov
- Egea Jorge GarcĂa
- El Muhtaseb Mohammad S
- El-Massoudi Youssef
- Elhadi Muhammed
- Elshennawy Eslam M
- Enriquez-Navascués José M
- Erdinc Kemal
- Eriksen Jacob D
- Ersryd Amanda L
- EscartĂn Jorge
- EspĂn-Basany Eloy
- Estaire-GĂłmez Mercedes
- EstefanĂa Diego
- Ewedah Moataz
- Fabbri NicolĂČ
- Fares Hala
- Farguell Jordi
- Faria Luis Queiroz
- Farnesi Francesca
- Fazzin Marta
- Feo Carlo V
- Ferenschild Floris T
- FernĂĄndez Cristina LĂłpez
- FernĂĄndez-Hevia MarĂa
- FernĂĄndez-Hevia MarĂa
- FernĂĄndez-Hurtado Ignacio
- FernĂĄndez-MartĂnez Daniel
- FernĂĄndez-MartĂnez Daniel
- Ferreira CĂĄtia
- Ferreira Rita Marques
- Ferrer RocĂo
- Filimonov Victor B
- Filipov Emil
- Fioravanti Emanuela
- Flamey Nicolas
- Florea Sabrina
- Folkesson Joakim
- Foppa Caterina
- Foppa Caterina
- Forgan Tim
- Fowler George E
- Frasson Matteo
- Frivold Tone
- Frontali Alice
- Fujiwara Hajime
- Futaba Kaori
- Gaard Maria
- Gadan Soran
- Galleano Raffaele
- Gallo Gaetano
- GarcĂa-FlĂłrez Luis J
- GarcĂa-FlĂłrez Luis J
- Gareb Fahed
- Garmanova Tatiana
- Garulli Gianluca
- Gecim Ibrahim E
- Geitenbeek Ritch
- George Sarah
- Ghazouani Omar
- Ghignone Federico
- Ghmagh Reem
- Gialamas Eleftherios
- Gielis Manuel
- Gil Lopez Jose M
- Giuffrida Mario
- Golshani Parisa
- Gonzalez Ricardo
- GonzĂĄlvez Paula
- Goutard Claire-Angéline
- Grass Julia-Kristin
- Graure Giorgiana M
- Gregussen Hilde
- Greijdanus Nynke G
- Gribnev Petar
- Grosek Jan
- Grossi Ugo
- Grotenhuis Brechtje A
- GrĂŒter Alexander A J
- Guel-Klein Safak
- Guenin Marc-Olivier
- Gurjar Shashank
- GĂłmez Tania
- GĂłmez-Abril Segundo Ă
- GĂłmez-Jurado MarĂa J
- GöbĂŒt HĂŒseyin
- GĂŒnenç ErĆan
- GĂŒrtler Thomas
- GĂŒzel Melek
- Haberal Elifcan
- Haddad Anis
- Hajjaj Baraa Nabil
- Hamdan Alaa
- Hamid Hytham K S
- Hammoodi Hayder
- Hani Mohammad Bani
- Hannink Gerjon
- Hasan Bassam
- Hassan Naya
- Hassan Soha Y
- Havenga Klaas
- Hazen Sanne J A
- Heemskerk Jeroen
- Heesink Vera
- Heidsma Charlotte M
- Heijnen Bob H M
- Herman Ayesiga
- HernĂĄndez Miguel
- Herrero Eduardo Ferrero
- Hess Gabriel F
- Ho Man-Fung
- Ho Yiu M
- Hoff Christiaan
- Hol Jeroen C
- Hollington Paul
- Holman Fabian A
- Hompes Roel
- Hoogteijling Tijs J
- Hulshof Lorenzo G W L
- Hussein Mohamed
- Iacomino Alessandro
- Ibrahim Aini F
- Ismail Razif
- Ivanov Tsvetomir
- Iversen Lene H
- Jadid Kaveh Dehlaghi
- Jakubauskas Matas
- Jakubauskiene Lina
- Jangmalm Staffan
- Janssen Paul T J
- Jou-Valencia Daniela
- Julaihi Rokayah
- Jutesten Henrik
- Kacem Montasser
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- Karsten Tom
- Karydakis Lysandros
- Kaya Tayfun
- Kelly Michael E
- Keskin Metin
- Ketelaers Stijn H J
- Khader Ahmed A E
- Khedr Gehan Abd Elatti
- Koc Mehmet A
- Koemans Willem J
- Konishi Tsuyoshi
- Korkolis Dimitrios
- Kostromitskiy Dmitriy N
- Kozan Ramazan
- KoĆĄir Jurij A
- Kraft Miquel
- Krastev Panche
- Krohn Nina
- Kroon Hidde M
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- Kulle Cemil B
- Kulle Cemil B
- Kusters Miranda
- Kynaston James
- Lacy Antonio M
- Lambrechts Anton
- Lamme Bas
- Lamparelli Michael
- Lantone Giuliano
- Lapolla Pierfrancesco
- Larcinese Antonella
- Larkin John O
- Larkin John O
- Larsson Per-Anders
- Latkauskas Tadas
- Lauka Lelde
- Leeuwenburgh Marjolein M
- Lefevre Jérémie H
- Leijtens Jeroen W A
- Leung Edmund
- LeventoÄlu Sezai
- Lindqvist Ebba
- Liu Jianliang
- Longhi Marco
- Lorenzon Laura
- Lorusso Leonardo
- Losada Manuel
- Lucchi Andrea
- LuncÄ Sorinel
- Lutfi Hamid
- Lydrup Marie-Louise
- LĂłpez-Lara Manuel
- LĂłpez-RodrĂguez-Arias Francisco
- Macau Florin
- Machackova Maria
- Maghrebi Houcine
- Majbar Mohammed A
- Mak Tony Wing-Chung
- Manatakis Dimitrios
- Mansour Ali
- Manzo Carlo A
- Marchegiani Francesco
- Marcos Elena Bermejo
- Mariani NicolĂČ M
- Marinelli Andreas
- Markaryan Daniil G
- Maroli Annalisa
- Martins SĂłnia Fortuna
- MartĂnek LubomĂr
- MartĂnez MarĂa Labalde
- MartĂnez-Pinedo Carlos
- Maslyankov Svilen
- Massey Lisa
- Matthiessen Peter
- Mattioni Laura A
- McCormick Paul H
- McCullough Peter
- Medina Quintana Rita E
- Mehigan Brian J
- Melling Nathaniel
- Melnikov Andrey A
- Mendes Ana Filipa Dias
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- Mia Imraan
- Mikalauskas Saulius
- Mingoli Andrea
- Mishra Amitabh
- Mitteregger Martin
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- Moctezuma-VelĂĄzquez Paulina
- Mohamed Abudi
- Mohsine Raouf
- Monib Fatma A
- Monson John
- Montroni Isacco
- Morales Bernaldo de QuirĂłs Javier T
- Morgan Matthew
- Msherghi Ahmed A
- Mueller Simone
- Mugla Naser
- Muguerza Huguet José M
- Mukherjee Tanmoy
- Muratore Andrea
- Muriel Jorge Sancho
- Musters Gijsbert D
- Muñoz-Collado Salvador
- MuÈinÄ Ana-Maria
- MĂnguez-Ruiz GermĂĄn
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- Navarro-SĂĄnchez Antonio
- Neary Peter
- Negoi Ionut
- Negoita Valentina M
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- Oosterling Steven J
- Opocher Enrico
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- Parodi Matias
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- Pennings Alexander J
- Pereira Ricardo
- Perez Daniel
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- Polle Sebastiaan W
- Polydorou Adreas
- Porta Andrea
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- Pratschke Johann
- Pringle Heather C M
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- Rauf Hareem
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- RutegÄrd Martin
- Rutten Harm J T
- RuĂz-GarcĂa Pablo
- Ryan Jessica
- Rydbeck Daniel
- Saad Ahmad
- Sacchi Matteo M
- Sacchi Matteo M
- Sainz-HernĂĄndez Juan C
- Salgado-Nesme Noel
- Salomon Mario
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- Sammour Tarik
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- Sarmah Panchali
- Sarveswaran Janahan
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- Scheurink Lieke
- Schizas Dimitrios
- Schultz Johannes K
- Sebai Amine
- Sebastian Boby
- Segelman Josefin
- Seitinger Gerald
- SemiĂŁo Miguel
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- Sjo Ole H
- Sjöström Olle
- Skrovina Matej
- Sköldberg Filip
- Slavchev Mihail
- Slooter Gerrit D
- Smeeing Diederik P J
- Sokolov Manol
- Soler-Silva Ălvaro
- Solomon Michael
- Soriero Domenico
- Souadka Amine
- Spinelli Antonino
- Spinelli Antonino
- Spolverato Gaya
- Staffan Maria
- Stefanescu Victor
- Steller Arend G J Aalbers Ernst J
- Stienstra Roxane M
- Stoica Bogdan
- Stoica Bogdan
- Suchkov Igor A
- Sultan Hytham
- Surlin Valeriu M
- SuĂĄrez Marta Castro
- SuĂĄrez-SĂĄnchez Aida
- SuĂĄrez-SĂĄnchez Aida
- Syllaios Athanasios
- SĂĄnchez Lara Juan E
- SĂĄnchez Teresa Rubio
- Sånchez-Guillén Luis
- Sökmen SELMAN
- Tababa Osama W E
- Taha-Mehlitz Stephanie
- Talboom Kevin
- Talsma Aaldert K
- Tamelis Algimantas
- Tamini NicolĂČ
- Tanase Ioan
- Tanis Pieter J
- Tantoura Mohammad
- Tanzanu Marta
- Tasende-Presedo Marta M
- Tasis Nikolaos
- Taverne Sophie B M
- Tejedor Patricia
- Teras JĂŒri
- Teras Roland M
- Terra Antonio La
- Tiefenthal Marit
- Tomasicchio Giovanni
- TomaĆŸiÄ AleĆĄ
- Tonchev Pencho
- Toorenvliet Boudewijn R
- Torres MarĂa T
- Toso Christian
- Tsimogiannis Konstantinos
- Tuynmann Jurriaan B
- Tzovaras George
- Ubels Sander
- Ugolini Giampaolo
- Uluk Deniz
- Vailas Michail
- Vailati Bruna B
- van Dalsen Annette D
- van den Broek Nathalie E J
- van den Hengel Berber
- van der Burg Sjirk
- van der Zijden CharlĂšne J
- van Gerven Pieter
- van Kessel Charlotte S
- van Praagh Jasper B
- van Schaik Ted G
- van Westreenen Hendrik L
- van Workum Frans
- Vanclooster Patrick
- Vansteenbrugge Louis
- Vasile Mihai
- Venianaki Maria
- Verdaasdonk Emiel G G
- Vergara-FernĂĄndez Omar
- Vermaas Maarten
- Verstappen Sonja
- Vignotto Chiara
- Villar Ăscar GarcĂa
- Vittori Laura
- Vles Wouter J
- von FlĂŒe Markus
- Voron Thibault
- Vosbeek Noortje
- Vuagniaux Aurélie
- VĂĄzquez Andrea
- Waqar Usama
- Waqar Usama
- Ward Nicholas
- Warden Claire
- Westerterp Marinke
- Wienholts Kiedo
- Wiering Bastiaan
- Wijma Allard G
- Wildeboer Aurelia C L
- Wolthuis Albert
- Wong Michael P K
- Woods Kayla
- Xenaki Sofia
- Xynos Evangelos
- Yalkın Ămer
- Yanishev Alexey
- YĂŒksel Osman
- Zabala JesĂșs GĂłmez
- Zakaria Andee D
- Zakaria Zaidi
- Zanini Nicola
- Zanus Giacomo
- Zazo Aya
- Zazo Rama
- Zucchella Martino
- ZukanoviÄ Goran
- Zwakman Marije
- Ăakır Murat
- Ăzata Ä°brahim H
- ĂzgĂŒr Ä°lker
- Ăzkan Ămer Faruk
- ĂlgĂŒr Hanife Ćeyda
- Ć antak Goran
- Ć imleĆĄa Damir
- Ć lenfuktas Vygintas
- Ćœilinskas Justas
- Publication venue
- Publication date
- 01/01/2023
- Field of study
Objective:To develop and validate a prediction model (STOMA score) for 1-year stoma-free survival in patients with rectal cancer (RC) with anastomotic leakage (AL).Background:AL after RC resection often results in a permanent stoma.Methods:This international retrospective cohort study (TENTACLE-Rectum) encompassed 216 participating centres and included patients who developed AL after RC surgery between 2014 and 2018. Clinically relevant predictors for 1-year stoma-free survival were included in uni and multivariable logistic regression models. The STOMA score was developed and internally validated in a cohort of patients operated between 2014 and 2017, with subsequent temporal validation in a 2018 cohort. The discriminative power and calibration of the models' performance were evaluated.Results:This study included 2499 patients with AL, 1954 in the development cohort and 545 in the validation cohort. Baseline characteristics were comparable. One-year stoma-free survival was 45.0% in the development cohort and 43.7% in the validation cohort. The following predictors were included in the STOMA score: sex, age, American Society of Anestesiologist classification, body mass index, clinical M-disease, neoadjuvant therapy, abdominal and transanal approach, primary defunctioning stoma, multivisceral resection, clinical setting in which AL was diagnosed, postoperative day of AL diagnosis, abdominal contamination, anastomotic defect circumference, bowel wall ischemia, anastomotic fistula, retraction, and reactivation leakage. The STOMA score showed good discrimination and calibration (c-index: 0.71, 95% CI: 0.66-0.76).Conclusions:The STOMA score consists of 18 clinically relevant factors and estimates the individual risk for 1-year stoma-free survival in patients with AL after RC surgery, which may improve patient counseling and give guidance when analyzing the efficacy of different treatment strategies in future studies
Stoma-free survival after anastomotic leak following rectal cancer resection: worldwide cohort of 2470 patients
- Author
- Aalbers Arend G.J.
- Abbas Ayman
- Abbood Ali Hashim
- Abdeen Basel
- Abdelaal Ahmed Samir
- Abdullah Nik A.N.
- Abdulwahed Eman
- Abelevich Alexander
- Abujamra Saleh
- Acar Nihan CoĆgun
- Afzal Asma
- Agalianos Christos
- Agapov Mikhail N.
- Agostinelli Laura
- Ahmed Nagm Eldin Abu Elnga
- Ahmed Safia
- Aigner Felix
- Akyol Cihangir
- Al-Eryani Fatima
- Al-Juaifari Maytham A.
- Al-Najami Issam
- Alanez-Saavedra Javier
- Albakry Rudaina
- Alhardan Anas
- Alhisi Ahmed Jehad
- Ali Ahmed K.
- Alkady Eithar
- Allmer Caterina
- Alonso Alfredo
- Alrayes Bourhan M.H.
- Alshareea Entisar
- Altomare Donato F.
- Altrabulsi Amani
- Alvarez-Bautista Francisco E.
- Amano Takahiro
- Amelung Femke J.
- Anderin Kajsa
- Annicchiarico Alfredo
- Ansorena Yolanda Saralegui
- Antona Francisco Blanco
- Antonopoulou Maria-Ioanna
- Aprile Alessandra
- Aranda MarĂa J. Pizarro
- Aretxabala Izaskun del Hoyo
- Armao Francesca T.
- Arroyo Antonio
- Ashmore Daniel
- Ashoush Fouad M. Bassyouni
- Atak Ä°brahim
- Atanasov Boyko
- Atici Semra Demirli
- Atienza Paula GonzĂĄlez
- Avanagh Dara O.
- Avellaneda Nicolas
- Aversano Alessia
- Aybar Ahmet B. CiftciEngin
- Aydin Oguzhan
- Ayoub Kusay
- Azevedo Constanca
- Baatrup Gunnar
- Baban Bayar
- Badiani Sarit
- Bahadoer Renu R.
- Baili Efstratia
- Balalis Dimitrios
- Balci Bengi
- Balik Emre
- Ballabio Michele
- Baloyiannis Ioannis
- Barbero-Valenzuela Alejandro
- Bavikatte Akshay
- Bazaev Andrey
- Belev Nikolay
- Bellato Vittoria
- BeltrĂĄn de Heredia Juan P.
- Belvedere Angela
- Benkabbou Amine
- BenÄurik Vladimir
- Bernal-Sprekelsen Juan C.
- Berney Christophe
- Bethune Rob M.
- Bhandari Santosh
- Bhat Sameer
- Binder Alf-Dorian
- Biondi Alberto
- Bisagni Pietro
- Bislenghi Gabriele
- Bissett Ian
- BiĆgin Tayfun
- Bjorsum-Meyer Thomas
- Blas Juan L.
- Bloemen Johanne G.
- Boerma Evert-Jan G.
- Bonito Alba Correa
- Borda Francisco Javier GarcĂa
- Borda-Arrizabalaga Nerea
- Bottazzoli Elisa I.
- Boutall Adam
- Bouvy Nicole D.
- BoĆŸiÄ Tajda KoĆĄir
- Brachini Gioia
- Bradley Nicholas
- Bremers Andreas J.A.
- Buchs Nicolas
- Buchwald Pamela
- Bulut Mehmet Turker
- Burger Jacobus W.A.
- Burghgraef Thijs A.
- Busund Sondre
- Buzzi Gianluca
- BuÄra Dursun
- Calabro Marcello
- Calero-Lillo ArĂĄnzazu
- Calik Bulent
- Carbone Fabio
- Carreño-Villarreal Guillermo
- Carrie Augusto
- Carvello Michele
- Carvello Michele
- Catena Fausto
- Cengiz Fevzi
- Cerbo Daniele
- Ceretti Andrea P.
- Chandio Ashfaq
- Chaoui Ahmed
- Charalabopoulos Alexandros
- Chaudhri Sanjay
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- Chrysos Emmanuel
- Cifuentes-Ródenas José A.
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- Corbellini Carlo
- Cotte Eddy
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- Crescentini Giacomo
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- D'Alimonte Lucrezia
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- da Costa Devesa Helena M.
- da Silva Nigel
- Daester Silvio
- Darias IvĂĄn Soto
- Darlin Lotten
- Darwich Haitham
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- de Andrés Beatriz
- de Gheldere Charles
- de Graaf Eelco J.R.
- de Groot-Van Veen Irene
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- de Lacy F. Borja
- de Manzoni Giovanni
- de Nes Lindsey C.F.
- de Paola Gilda
- de Pasqual Carlo A.
- de Simone Belinda D.
- de Vriendt Stefanie
- de Wilt Johannes H.W.
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- Deeknah Abdulqudus
- Defoort Barbara
- deGiuli Maurizio
- Dekker Jan-Willem T.
- Delrio Paolo
- Demirkiran Ahmet
- den Boer Frank
- Denost Quentin
- Dewulf Maxime
- di Cosmo Maria A.
- Di Saverio Salomone
- Dimofte Gabriel-Mihail
- Dinaux Anne M.
- Dittrich Luca S.
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- Docampo Iria Losada
- Dogan Lutfi
- Doornebosch Pascal G.
- Drozdov Evgeniy S.
- Dudi-Venkata Nagendra N.
- Dursun Ayberk
- Duzgun Ozgul
- Dziakova Jana
- DĂez-Alonso Manuel
- Echaniz Garazi Elorza
- Echiguer Sabrillah
- Eduard Galliamov
- Egea Jorge GarcĂa
- el Muhtaseb Mohammad S.
- El-Massoudi Youssef
- Elhadi Muhammed
- Elshennawy Eslam M.
- Enriquez-Navascués José M.
- Erdinc Kemal
- Eriksen Jacob D.
- Ersryd Amanda L.
- EscartĂn Jorge
- EspĂn-Basany Eloy
- Estaire-GĂłmez Mercedes
- Estefania Diego
- Ewedah Moataz
- Fabbri Nicolo
- Fares Hala
- Farguell Jordi
- Faria Luis Queiroz
- Farnesi Francesca
- Fazzin Marta
- Feo Carlo V.
- Ferenschild Floris T.
- FernĂĄndez C.L.
- FernĂĄndez-Hevia MarĂa
- FernĂĄndez-Hurtado Ignacio
- FernĂĄndez-MartĂnez Daniel
- Ferreira Catia
- Ferreira Rita Marques
- Ferrer RocĂo
- Filimonov Victor B.
- Filipov Emil
- Fioravanti Emanuela
- Flamey Nicolas
- Florea Sabrina
- Folkesson Joakim
- Foppa Caterina
- Foppa Caterina
- Forgan Tim
- Fowler George E.
- Frasson Matteo
- Frivold Tone
- Frontali Alice
- Fujiwara Hajime
- Futaba Kaori
- Gaard Maria
- Gadan Soran
- Galleano Raffaele
- Gallo Gaetano
- GarcĂa-FlĂłrez Luis J.
- Gareb Fahed
- Garmanova Tatiana
- Garulli Gianluca
- Gecim Ibrahim E.
- Geitenbeek Ritch
- George Sarah
- Ghazouani Omar
- Ghignone Federico
- Ghmagh Reem
- Gialamas Eleftherios
- Gielis Manuel
- Giuffrida Mario
- Gobut Huseyin
- Golshani Parisa
- Gonzalez Ricardo
- GonzĂĄlvez Paula
- Goutard Claire-Angéline
- Grass Julia-Kristin
- Graure Giorgiana M.
- Gregussen Hilde
- Greijdanus Nynke G.
- Gribnev Petar
- Grosek Jan
- Grossi Ugo
- Grotenhuis Brechtje A.
- Gruter Alexander A.J.
- Guel-Klein Safak
- Guenin Marc-Olivier
- Gunenc ErĆan
- Gurjar Shashank
- Gurtler Thomas
- Guzel Melek
- GĂłmez Tania
- GĂłmez-Abril Segundo Ă.
- GĂłmez-Jurado MarĂa J.
- Haberal Elifcan
- Haddad Anis
- Hajjaj Baraa Nabil
- Hamdan Alaa
- Hamid Hytham K.S.
- Hammoodi Hayder
- Hani Mohammad Bani
- Hannink Gerjon
- Hasan Bassam
- Hassan Naya
- Hassan Soha Y.
- Havenga Klaas
- Hazen Sanne J.A.
- Heemskerk Jeroen
- Heesink Vera
- Heidsma Charlotte M.
- Heijnen Bob H.M.
- Herman Ayesiga
- HernĂĄndez Miguel
- Herrero Eduardo Ferrero
- Hess Gabriel F.
- Ho Man-Fung
- Ho Yiu M.
- Hoff Christiaan
- Hol Jeroen C.
- Hollington Paul
- Holman Fabian A.
- Hompes Roel
- Hoogteijling Tijs J.
- Huguet José M. Muguerza
- Hulshof Lorenzo G.W.L.
- Hussein Mohamed
- Iacomino Alessandro
- Ibrahim Aini F.
- Ismail Razif
- Ivanov Tsvetomir
- Iversen Lene H.
- Jadid Kaveh Dehlaghi
- Jakubauskas Matas
- Jakubauskiene Lina
- Jangmalm Staffan
- Janssen Paul T.J.
- Jarimba Aldo M. Rodrigues
- Jou-Valencia Daniela
- Julaihi Rokayah
- Jutesten Henrik
- Kacem Montasser
- Kader Rawaz
- Kamer Erdinc
- Kapadia Raj
- Kara Yasin
- Karamanliev Martin
- Karavokyros Ioannis
- Karmi Fahed
- Karsten Tom
- Karydakis Lysandros
- Kaya Tayfun
- Kelly Michael E.
- Keskin Metin
- Ketelaers Stijn H.J.
- Khader Ahmed A.E.
- Khedr Gehan Abd Elatti
- Koc Mehmet A.
- Koemans Willem J.
- Konishi Tsuyoshi
- Korkolis Dimitrios
- Kostromitskiy Dmitriy N.
- Kozan Ramazan
- KoĆĄir Jurij A.
- Kraft Miquel
- Krastev Panche
- Krohn Nina
- Kroon Hidde M.
- Kryzauskas Marius
- Kulle Cemil B.
- Kulle Cemil B.
- Kusters Miranda
- Kynaston James
- La Terra Antonio
- Lacy Antonio M.
- Lambrechts Anton
- Lamme Bas
- Lamparelli Michael
- Lantone Giuliano
- Lapolla Pierfrancesco
- Lara Juan E. SĂĄnchez
- Larcinese Antonella
- Larkin John O.
- Larkin John O.
- Larsson Per-Anders
- Latkauskas Tadas
- Lauka Lelde
- Leeuwenburgh Marjolein M.
- Lefevre Jérémie H.
- Leijtens Jeroen W.A.
- Leung Edmund
- LeventoÄlu Sezai
- Lindqvist Ebba
- Liu Jianliang
- Longhi Marco
- Lopez Jose M. Gil
- Lorenzon Laura
- Lorusso Leonardo
- Losada Manuel
- Lucchi Andrea
- LuncÄ Sorinel
- Lutfi Hamid
- Lydrup Marie-Louise
- LĂłpez-Lara Manuel
- LĂłpez-RodrĂguez-Arias Francisco
- Macau Florin
- Machackova Maria
- Maghrebi Houcine
- Majbar Mohammed A.
- Mak Tony Wing-Chung
- Manatakis Dimitrios
- Mansour Ali
- Manzo Carlo A.
- Marchegiani Francesco
- Marcos Elena Bermejo
- Mariani NicolĂČ M.
- Marinelli Andreas
- Markaryan Daniil G.
- Maroli Annalisa
- Marques Sonia M. Ribeiro
- Martinek Lubomir
- Martins Sonia Fortuna
- MartĂnez MarĂa Labalde
- MartĂnez-Pinedo Carlos
- Maslyankov Svilen
- Massey Lisa
- Matthiessen Peter
- Mattioni Laura A.
- MatĂas-GarcĂa BelĂ©n
- McCormick Paul H.
- McCullough Peter
- Mehigan Brian J.
- Melling Nathaniel
- Melnikov Andrey A.
- Mendes Ana Filipa Dias
- Mendoza-Moreno Fernando
- Meroni Paola
- Mia Imraan
- Mikalauskas Saulius
- Mingoli Andrea
- Mishra Amitabh
- Mitteregger Martin
- Miu Victor
- Moctezuma-VelĂĄzquez Paulina
- Mohamed Abudi
- Mohsine Raouf
- Monib Fatma A.
- Monson John
- Montero José A. Alcåzar
- Montroni Isacco
- Morales Bernaldo de QuirĂłs Javier T.
- Morgan Matthew
- Msherghi Ahmed A.
- Mueller Simone
- Mugla Naser
- Mukherjee Tanmoy
- Muratore Andrea
- Muriel Jorge Sancho
- Musters Gijsbert D.
- Muñoz-Collado Salvador
- MuĆinÄ Ana-Maria
- MĂnguez-Ruiz GermĂĄn
- Nair Gavin
- Navarro-SĂĄnchez Antonio
- Neary Peter
- Negoi Ionut
- Negoita Valentina M.
- Nespoli Luca
- Ng Simon Siuman
- Niazi Ammar
- Nichita Vladimir-Ion
- Niemer Quirine
- Nieto-Moreno Elena
- Nilsson Karl
- Nonner Joost
- Novello Simone
- Nygren Jonas
- O'Grady Greg
- Obihara Ndidi J.
- Oldani Massimo
- Oliveira Antonio
- Oosterling Steven J.
- Opocher Enrico
- Osborne Laura
- Ozata Ä°brahim H.
- Ozgur Ä°lker
- Ozkan Omer Faruk
- Pachajoa Diana A. Pantoja
- Palini Gian M.
- Panel Nathalie
- Panis Yves
- Parc Yann
- Parise Cristiano
- Park Jennifer M.
- Parodi Matias
- Pasini Francesco
- Pasini Franceso
- Passuello Nicola
- Pattyn Paul
- Pavlov Vasil
- Peeters Koen C.M.J.
- Pellino Gianluca
- Pennings Alexander J.
- Pereira Ricardo
- Perez Daniel
- Perez Rodrigo O.
- Perivoliotis Konstantinos
- Perrone Gennaro
- Persiani Roberto
- Pesce Antonio
- Petropolou Thalia
- Pezzuto Roberto
- Picciariello Arcangelo
- Picone Emanuele
- Pikuniene Ingrida
- Pinto Francisca Lima
- Pire-Abaitua Gerardo
- Pirozzolo Giovanni
- PiyadeoÄlu Deniz
- Plastiras Aris
- Pletinckx Pieter
- Polat Fatih
- Polle Sebastiaan W.
- Polydorou Adreas
- Porta Andrea
- Poskus Tomas
- Pratschke Johann
- Pringle Heather C.M.
- Puca Lucia
- Pucciarelli Salvatore
- Qandeel Mahmoud W.M.
- Quintana Rita E. Medina
- Quiroga Ignacio Bodega
- Quiroga-ValcĂĄrcel Ana
- Rabadi Alexander
- Ramboiu Stefan Patrascu Sandu D.
- Ramsay George
- Rani Pallavi
- Rani Pallavi
- Rauf Hareem
- Rauf Hareem
- Recordare Alfonso
- Reddavid Rossella
- Rega Daniela
- Reudink Muriël
- Riedl Peter
- Riis Rolf
- Ripoli Maria Cristina
- Ris Frederic
- Rizzo Gianluca
- RoatÄ Cristian-Ene
- Rodimov Sergey V.
- RodrĂguez Carlos SĂĄez-Cazallas
- RodrĂguez-Infante Antonio
- Romano Angela
- Rompou Aliki
- Roos Daphne
- Roscio Francesco
- Rosman Camiel
- Rotholtz Nicolas
- Rottoli Matteo
- Ruiz Hernan
- Runau Francois
- RutegÄrd Martin
- Rutten Harm J.T.
- RuĂz-GarcĂa Pablo
- Ryan Jessica
- Rydbeck Daniel
- Saad Ahmad
- Sacchi Matteo M.
- Sacchi Matteo M.
- Sainz-HernĂĄndez Juan C.
- Salgado-Nesme Noel
- Salomon Mario
- Sambucci Daniele
- Sammarco Giuseppe
- Sammour Tarik
- Sampietro Gianluca M.
- Samsa Mehmet Veysi
- Santacruz Carlos CerdĂĄn
- Santillan Mateo
- Santoro Giulio A.
- Sari Ahmet Can
- Sarmah Panchali
- Sarveswaran Janahan
- Sauvain Marc-Olivier
- Scabini Stefano
- Scheurink Lieke
- Schizas Dimitrios
- Schultz Johannes K.
- Sebai Amine
- Sebastian Boby
- Segelman Josefin
- Seitinger Gerald
- Semiao Miguel
- Septiem Javier GarcĂa
- Serralta Daniel
- Shaban Mohamed
- Shaikh Shafaque
- Shapiro Joël
- Siaw Oliver
- Sibiç Osman
- Sica Giuseppe
- Sietses Colin
- Singh Baljit
- Singh Nirbhaibir
- Singh-Ranger Deepak
- Sinibaldi Giovanni
- Siragusa Leandro
- Sivrikoz Emre
- Sjo Ole H.
- Sjostrom Olle
- Skrovina Matej
- Sköldberg Filip
- Slavchev Mihail
- Slooter Gerrit D.
- Smeeing Diederik P.J.
- Sokmen Selman
- Sokolov Manol
- Soler-Silva Ălvaro
- Solomon Michael
- Soriero Domenico
- Souadka Amine
- Spinelli Antonino
- Spinelli Antonino
- Spolverato Gaya
- Staffan Maria
- Stefanescu Victor
- Steller Ernst J.
- Stienstra Roxane M.
- Stoica Bogdan
- Stoica Bogdan
- Suchkov Igor A.
- Sultan Hytham
- Surlin Valeriu M.
- SuĂĄrez Marta Castro
- SuĂĄrez-SĂĄnchez Aida
- Syllaios Athanasios
- SĂĄnchez Teresa Rubio
- Sånchez-Guillén Luis
- Tababa Osama W.E.
- Taha-Mehlitz Stephanie
- Talboom Kevin
- Talsma Aaldert K.
- Tamelis Algimantas
- Tamini NicolĂČ
- Tanase Ioan
- Tanis Pieter J.
- Tantoura Mohammad
- Tanzanu Marta
- Tasende-Presedo Marta M.
- Tasis Nikolaos
- Taverne Sophie B.M.
- Tejedor Patricia
- Teras Juri
- Teras Roland M.
- Tiefenthal Marit
- Tomasicchio Giovanni
- TomaĆŸiÄ AleĆĄ
- Tonchev Pencho
- Toorenvliet Boudewijn R.
- Torres MarĂa T.
- Toso Christian
- Tsimogiannis Konstantinos
- Tuynmann Jurriaan B.
- Tzovaras George
- Ubels Sander
- Ugolini Giampaolo
- Ulgur Hanife Ćeyda
- Uluk Deniz
- Vailas Michail
- Vailati Bruna B.
- van Dalsen Annette D.
- van den Broek Nathalie E.J.
- van den Hengel Berber
- van der Burg Sjirk
- van der Zijden CharlĂšne J.
- van Gerven Pieter
- van Kessel Charlotte S.
- van Praagh Jasper B.
- van Schaik Ted G.
- van Westreenen Hendrik L.
- van Workum Frans
- Vanclooster Patrick
- Vansteenbrugge Louis
- Vasile Mihai
- Venianaki Maria
- Verdaasdonk Emiel G.G.
- Vergara-FernĂĄndez Omar
- Vermaas Maarten
- Verstappen Sonja
- Vignotto Chiara
- Villar Ăscar GarcĂa
- Vittori Laura
- Vles Wouter J.
- von Flue Markus
- Voron Thibault
- Vosbeek Noortje
- Vuagniaux Aurelie
- VĂĄzquez Andrea
- Waqar Usama
- Waqar Usama
- Ward Nicholas
- Warden Claire
- Westerterp Marinke
- Wienholts Kiedo
- Wiering Bastiaan
- Wijma Allard G.
- Wildeboer Aurelia C.L.
- Wolthuis Albert
- Wong Michael P.K.
- Woods Kayla
- Xenaki Sofia
- Xynos Evangelos
- Yalkin Omer
- Yanishev Alexey
- Yuksel Osman
- Zabala JesĂșs GĂłmez
- Zakaria Andee D.
- Zakaria Zaidi
- Zanini Nicola
- Zanus Giacomo
- Zazo Aya
- Zazo Rama
- Zucchella Martino
- ZukanoviÄ Goran
- Zwakman Marije
- Ăakir Murat
- ÄosiÄ Jurica
- Ć antak Goran
- Ć imleĆĄa Damir
- Ć lenfuktas Vygintas
- Ćœilinskas Justas
- Publication venue
- Publication date
- 01/12/2023
- Field of study
Background: The optimal treatment of anastomotic leak after rectal cancer resection is unclear. This worldwide cohort study aimed to provide an overview of four treatment strategies applied. Methods: Patients from 216 centres and 45 countries with anastomotic leak after rectal cancer resection between 2014 and 2018 were included. Treatment was categorized as salvage surgery, faecal diversion with passive or active (vacuum) drainage, and no primary/secondary faecal diversion. The primary outcome was 1-year stoma-free survival. In addition, passive and active drainage were compared using propensity score matching (2: 1). Results: Of 2470 evaluable patients, 388 (16.0 per cent) underwent salvage surgery, 1524 (62.0 per cent) passive drainage, 278 (11.0 per cent) active drainage, and 280 (11.0 per cent) had no faecal diversion. One-year stoma-free survival rates were 13.7, 48.3, 48.2, and 65.4 per cent respectively. Propensity score matching resulted in 556 patients with passive and 278 with active drainage. There was no statistically significant difference between these groups in 1-year stoma-free survival (OR 0.95, 95 per cent c.i. 0.66 to 1.33), with a risk difference of -1.1 (95 per cent c.i. -9.0 to 7.0) per cent. After active drainage, more patients required secondary salvage surgery (OR 2.32, 1.49 to 3.59), prolonged hospital admission (an additional 6 (95 per cent c.i. 2 to 10) days), and ICU admission (OR 1.41, 1.02 to 1.94). Mean duration of leak healing did not differ significantly (an additional 12 (-28 to 52) days). Conclusion: Primary salvage surgery or omission of faecal diversion likely correspond to the most severe and least severe leaks respectively. In patients with diverted leaks, stoma-free survival did not differ statistically between passive and active drainage, although the increased risk of secondary salvage surgery and ICU admission suggests residual confounding
Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries
- Author
- Aarts Frits
- Ababneh Hazim
- Abad-Motos Ane
- Abaidalla Ahmed
- Abbakar Malaz
- Abd El Aal Ahmed
- Abd-Errazik Mohammad Ahmad
- Abdalradiy Abdalrahmman G
- Abdelkhalek Mohamed
- Abdelkhalek Mostafa
- Abdellatif Ahmed
- Abdellatif Mohamed
- Abdelsaid Kirolas
- Abdou Khaled
- Abdulfatah Mustapha
- Abdullah Mohammad Amer
- Abdullahi Mustapha Miko Mohammed
- AbellĂĄn Antonio Melero
- Abeysinghe Nayana
- Abiyere Henry
- Achimas-Cadariu Patriciu Andrei
- Adakaya Sıla
- Adam Nicolas
- Adams Benita
- Adams Ferdinand
- Adegboye Kazeem
- Adeyeye Ademola
- Adra Lama
- Adu-Poku Patricia
- Afuwape Oludolapo
- Afzal Ameer
- Afzal Muhammad Farooq
- Agapov Mihail
- Agara Daniel
- Aggarwal Manisha
- Agger Erika
- Aghadi Ifeanyi Kene
- Ahmed Amjed Yassir
- Ahmed Haleemasahdia
- Ahmed Khalil
- Ahmed Manar
- Ahmed Masood
- Ahmed Safia
- Ahn Hong Min
- Aibe Raquel
- Aigner Felix
- Aissat Abdenour
- Aitbaeva Arai
- Akay Omer
- Akbar Ali
- Akbas Ahmet
- Akere Abidemi
- Akesen Selcan
- Akgun Erhan
- Akhtar Naseem
- Akın Emrah
- Akova Elif
- Aktas Serhat
- Akçay Ăzlem
- Al Masri Mahmoud
- Al-Alnsi Ahmed
- Al-Hutheifi Roqia'A
- Al-Jarrah Amar
- Al-Naggar Hamza
- Al-Shehari Mohammed
- Alamin Nadeen
- Alawi Raneen
- Alawlaqi Dina
- Alawneh Fade
- Alberola Maria José
- Albers Michael
- Alcolea Natalia GonzĂĄlez
- Aleem Muhammad
- Alegre InĂȘs
- Alegre Javier Martinez
- Alexandre Flavia
- Alexandrescu Corina
- Alexnder Abelevich
- Alexopoulou Kalliopi
- Alfonso Beatriz AmorĂłs
- Ali Ahmed
- Ali Che Saniati Che
- Ali Danish
- Ali Madeeha
- Ali Mahmoud Abdelwahab
- Ali Manhal Hashim
- Ali Noura Al
- Alikhanli Jhale
- Aliyeva Zumrud
- Aliyu Mohammed
- Aljawder Hasan
- Allen Kate
- Almahmeed Ebrahim
- Alonso Alfredo
- Alonso Javier Etreros
- Alsamneh Muneer
- Alsayadi Ramzi
- Altinel Yuksel
- Altintoprak Fatih
- Altomare Donato F
- Alvarenga Isabella
- Alvarez Laura Jimenez
- Alvarez-Bautista Francisco Emmanuel
- Alvarez-DĂez Marcos
- Alves Brenda Chayanny
- Amadigwe Rita
- Amado Andreia
- Amado FabĂola
- Amador Cristina GarcĂa
- Amanullah Nazli
- Amaral HĂ©lida Aline Tomacheski
- Amaral Luis
- Amin-Tai Hizami
- Aminu Bashiru
- Amir Ahmad Suhaimi
- Ammar Ahmed Siddique
- Ammar Mona Ahmed
- Ammendola Michele
- Ammerata Giorgio
- Amorim Edgar
- Ancans Guntis
- Anderson Tom
- Andrade Diogo
- Andrejevic Predrag
- AndrĂ©s Beatriz DĂaz San
- Anestiadou Elissavet
- Ang Chin Wee
- Angelo Franceschi
- Anokhin Evgeny
- Anoldo Pietro
- Antakia Ramez
- Anton Majd
- Antonelli Serena
- Antropoli Carmine
- Anula Rocio
- Anwar Jamal
- Anyadike Florence
- Apostolakidou Magda
- Apostolidi Eirini
- Aprea Giovanni
- Arabadzhiev Angel
- Arakawa Satoshi
- Arauz Jazmin
- Aravindan U
- Aremu Abdurrahman
- Aremu Isiaka
- Argawy Osama
- Arican Can
- Arida Zahed Abu
- Armellin Claudia
- Arnaoutoglou Eleni
- Arreguy-Borges Kanthya
- Artigot Mariano
- Arturi Alessandro
- Arulappan Nirupama
- Arya Shobhit
- Arynov Ardak
- Asaad Peter
- Asano Yukio
- Ascari Francesca
- Asgarov Mohsum
- Ashmawy Soad
- Aslam Muhammad Imran
- Assimakopoulou Elena
- Assis Ana
- Astilleta Romina
- Atanasov Boyko
- Atendido Tiffany
- Athanasakis Elias
- Atici Semra Demirli
- Avellaneda Nicholas
- Avellaneda Nicolas
- Avseren Goksu
- Awead Marwa
- Ayandipo Omobolaji
- Aybar Engin
- Aydin Funda
- Aydin Gaye
- Ayoub Kusay
- Aytac Erman
- Aytaç Erman
- Azevedo Jose
- Azevedo Patricia
- Azhar Najia
- Aziz Gowhar
- Azman Zairul Azwan Mohd
- AĆkar Ahmet
- Babatunde Olanrewaju
- Badawi Marwa
- Baek Jeong-Heum
- Baez Noelia FernĂĄndez
- Baeza-Murcia Melody
- Bagnardi Francesco
- Baharom Salahudin
- Baik Seung Hyuk
- Baimakhanov Abylai
- Bains Lovenish
- Baker Aleksandra
- Bakmaz Bernarda
- Bala Abubakar Muhammad
- Balaban Vladimir
- Balalis Dimitrios
- Balasubramaniam Dinesh
- Balathayalan Yathev
- Baldi Claudio
- Balestri Riccardo
- Balfour James
- Ballah Abubakar
- Ballian Nikiforos
- Balooshi Iman Al
- Baloyiannis Ioannis
- Bamford Richard
- Bandar Mahdi Al
- Banham Gail
- Bannoud Mohammad Hassan
- Baptista Victor
- Baral Jörg
- Barbalace Nicolas
- Barbato Giuseppe
- Barbosa Anderson
- Bareka Metaxia
- Baris Baver
- Barradas Renato
- Barreda Sara Castillo
- Barrena-Blazquez Silvestra
- Barton Jess
- Bartosiak Katarzyna
- Bashilkina Olga
- Bashir Mohammed
- Basile Raffaele
- Basnyat Pradeep
- Batool Sana
- Bautista Wilson Manuel SĂĄnchez
- Bayhan ZĂŒlfĂŒ
- Bayo José Manuel Muros
- BayĂłn Raquel Ălvaro
- Baños Pedro Antonio Parra
- Beard David
- Bedzhanyan Arkady
- Behilil Chakib
- Bekele Kebebe
- Belarmino Armin
- Belay Million
- Belev Nikolay
- Bellato Vittoria
- BeltrĂĄn de Heredia Juan
- Belvedere Angela
- Benetti Emilio
- Benetti Sara
- Bengueddach Aicha
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- Vecchio Pablo
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- Zafar Madiha
- Zagaynov Eugeny
- Zaidi Syed-Nadeem
- Zaimis Tilemachos
- Zain Wan Zainira Wan
- Zainy Rhendra Hardy Mohamad
- Zakaria Andee Dzulkarnaen
- Zakaria Maheen
- Zakaria Zaidi
- Zamudio-Bautista Jorge Luis
- Zanc Loredana
- Zanoni Andrea
- Zanus Giacomo
- Zapparoli Alessandro
- Zappone Anna
- Zarzava Eirini
- Zatari Dirar
- Zawadzki Marek
- Zayakov Georgi
- Zaycev Andrey
- Zazo Aya
- Zazo Rama
- Zdravkovic Maja
- Zengin Abdullah KaÄan
- Zeringa Georgia
- Zimmerman David D E
- Zuhdy Mohammad
- Zvirych Vitalii
- Zywicka Ewa
- Ălvarez-Llano Laura
- Ăngelo Miguel Duarte
- ĂSullivan Sara Nuñez
- Ăzçelik Mehmet Faik
- Äoza Ivo
- Ćanlı Ahmet Necati
- Publication venue
- Publication date
- 01/01/2023
- Field of study
Background
Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks.
Methods
The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned.
Results
A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31).
Conclusion
Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)