| Contributors: |
Negoi, Ionut; Van Ramhorst, Gabrielle; Sebastian, Shaji; Pellino, Gianluca; Elhadi, Muhammed; Dulskas, Audriu; Kadir, Bryar; Glasbey, Jame; Neary, Peter; María Minaya Bravo, Ana; Keatley, Jame; El-Hussuna, Alaa; Pinkney, Thoma; Chaudhry, Sanjay; Magill, Laura; Perry, Rita; Blackwell, Sue; Chaudhri, Sanjay; Chowdhury, Sharfuddin; Dardanov, Dragomir; Foppa, Caterina; Gallo, Gaetano; Li, Elizabeth; Morton, Dion; Pata, Francesco; Van Ramshorst, Gabrielle; Silva Mendes, Beatriz; Singh, Baljit; Aytac, Erman; Breukink, Stephanie; Buchwald, Pamela; Christou, Niki; Horesh, Nir; Horisberger, Karoline; Khan, Jim; Koskenvuo, Laura; Košir, Yurij; Lederhuber, Han; Shalaby, Mostafa; Vaizey, Carolynne; Bilali, S; Ferko, S; Gjata, A; Shehi, E; Shahu, J; Bouaoud, S; Abdoun, M; Bouchenak, K; Saada, H; Ouyahia, A; Rais, M; Seddik, E; Bouaoud, M; Kouicem, A; Yacine, N; Nawel, L; Talbi, N; Tidjane, A; Tabeti, B; Hebbar, A; Lalmi, I; Bouanani, A; Bali, O; Benallel, N; Chwat, C; Lemme, G; Rosato, G; Alexandre, F; Valli, D; Gosselink, M; Daryanani, D; Smit, J; Ponson, A; Casseres, Y; Strugnell, N; D'Souza, B; Badiani, S; Kuany, T; Aigner, F; Mitteregger, M; Uranitsch, S; Allmer, C; Moitzi, G; Wallner, E; Stadler, R; Herbst, F; Iliev, I; Samadov, E; Ibrahimli, A; Saeed, M; Varkey, R; Ebrahim, B; Aljazaf, H; Juma, I; Monami, B; Markiewicz, S; Francart, D; Jehaes, F; Debergh, N; Malvaux, P |
| Description: |
Introduction: Benchmarking colorectal surgery outcomes informs quality improvement. The ESCP CORREA 2022 snapshot audit aimed to assess contemporary colorectal resection practices and short-term outcomes across European countries and beyond. Methods: An international prospective multicentre audit was conducted in which adults undergoing elective or emergency colorectal resection during a 6-week period (January-April 2022) at participating hospitals were included. Data on patient demographics, indications, surgical approach (open, laparoscopic or robotic) and 30-day postoperative outcomes (complications, reoperation and mortality) were collected for analysis. The outcomes were analysed and compared with those of previous audits to identify trends in colorectal surgery. Results: The study enrolled 3521 patients (56.8% men) from 216 hospitals across 53 countries. In 72.2% of the cases, the indication for resection was malignancy, followed by diverticular disease in 9.0%, Crohn's disease in 3.7% and ulcerative colitis in 2.3% of the cases. Of the surgeries, 74.4% were elective. Minimally invasive surgery was performed in 55.2% of the cases (48.7% laparoscopic and 6.5% robotic). Primary anastomosis was performed in 90.3% of the patients. The 30-day anastomotic leak rate was 7.96%; in malignant and benign diseases, the leak rates were 7.3% and 10.2%, respectively. The leak rates for right, left, anterior rectal resection, pouch and subtotal colectomy were 6.9%, 7.7%, 9.7%, 16.0% and 11.8%, respectively. In the multivariable analysis, the risk factors for leakage included male sex (9.3% vs. 6.3%, OR = 0.69, 95% CI 0.51-0.95, p = 0.023) and emergency surgery (11.4% vs. 7.1%, OR = 1.58, 95% CI 1.10-2.27, p = 0.013). Thirty-day mortality was 2.38%. Conclusions: This large international audit provides the status of the management of colorectal surgery. This shows that minimally invasive techniques are widely adopted, and 30-day mortality is low; however, anastomotic leak rates remain persistently high. These findings ... |