by University of Birmingham

Modified PICO graph for EAGLE study*Harmonizing of intraoperative techniques is a suite of learning materials, discussions, and operative videos that explore the challenges that may face surgeons during operation and supports surgeons’ decision-making by presenting the best evidence available on how to tackle these challenges. PICO, patients, intervention, comparator, outcome. Credit: British Journal of Surgery (2023). DOI: 10.1093/bjs/znad370

Patients around the world needing colonic surgery may be less likely to experience major complications after surgeons received online education run by the University of Birmingham's Global Surgery Unit.

The reduction in anastomotic leaks taking place following types of colon surgery, including right colectomy, is analyzed in a new publication in the British Journal of Surgery. The research team for the EAGLE trial, coordinated by the University of Birmingham, found that surgical teams that completed an online education module and followed more harmonized surgical techniques saw a substantial (50%) reduction in leaks.

Professor Dion Morton OBE, Barling Professor of Surgery at the University of Birmingham and senior author of the paper, said, "Complications from colonic surgery leading to anastomotic leaks are not infrequent and can be life-threatening, affecting around one in 12 patients undergoing bowel resection. We set out to provide expert training in the form of an online education module that surgical teams undertook as part of the EAGLE study. We are delighted to see that among those teams who took part in the trial and completed the module, there was a sizeable reduction in the number of leaks following surgery."

"Now that we have demonstrated that EAGLE resources can help to reduce this serious complication, we are providing the educational package across the world for free so that as many patients as possible can benefit."

Anastomotic leaks are where two sections of the channel in the gut that have been operated on aren't joined together correctly. This leads to the contents of the patients' gut leaking into the surrounding tissue including gut bacteria. It is associated with a five-fold increase in mortality following surgery.

Dr. Elizabeth Li, Academic Clinical Lecturer in Surgery at the University of Birmingham and corresponding author of the study, said, "Our findings reflect the importance of team building in surgical departments and the strong connection of this into improved patient outcomes. The EAGLE study was a global collaborative effort and represents the beginning of a new method of delivering education and behavioral change in surgery."

More information: Dion Morton et al, Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries, British Journal of Surgery (2023). DOI: 10.1093/bjs/znad370

Journal information: British Journal of Surgery 

Provided by University of Birmingham