Study protocol for a multicenter prospective cohort study on esophagogastric anastomoses and anastomotic leak (the Oesophago-Gastric Anastomosis Audit/OGAA)

Research output: Contribution to journalArticle

Authors

  • R. P. T. Evans
  • P. Singh
  • D. Nepogodiev
  • J. Bundred
  • S. Kamarajah
  • And 11 others
  • B. Jefferies
  • K. Siaw-Acheampong
  • K. Wanigasooriya
  • S. McKay
  • I. Mohamed
  • T. Whitehouse
  • D. Alderson
  • J. Gossage
  • R. van Hillegersberg
  • R. S. Vohra
  • E. A. Griffiths

Colleges, School and Institutes

External organisations

  • West Midlands Research Collaborative (WMRC), West Midlands, UK.
  • Department of Upper GI Surgery, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham.
  • Academic Department of Surgery
  • Academic Department of Anaesthesia
  • The Royal College of Surgeons England.
  • Department of Upper GI Surgery, St Thomas' Hospital, Guys and St. Thomas' Foundation Trust, London.
  • Department of Medical Oncology, University Medical Center Utrecht, Utrecht, Netherlands.
  • Queen's Medical Centre, Nottingham University Hospitals' NHS Trust, Nottingham, UK.

Abstract

Esophagectomy is a mainstay in curative treatment for esophageal cancer; however, the reported techniques and outcomes can vary greatly. Thirty-day mortality of patients with an intact anastomosis is 2-3% as compared to 17-35% in patients who have an anastomotic leak. The subsequent management of leaks postesophagectomy has great global variability with little consensus on a gold standard of practice. The aim of this multicentre prospective audit is to analyze current techniques of esophagogastric anastomosis to determine the effect on the anastomotic leak rate. Leak rates and leak management will be assessed to determine their impact on patient outcomes. A 12-month international multicentre prospective audit started in April 2018 and is coordinated by a team from the West Midlands Research Collaborative. This will include patients undergoing esophagectomy over 9 months and encompassing a 90-day follow-up period. A pilot data collection period occurred at four UK centers in 2017 to trial the data collection form. The audit standards will include anastomotic leak and the conduit necrosis rate should be less than 13% and major postoperative morbidity (Clavien-Dindo Grade III or more) should be less than 35%. The 30-day mortality rate should be less than 5% and the 90-day mortality rate should be less than 8%. This will be a trainee-led international audit of esophagectomy practice. Key support will be given by consultant colleagues and anesthetists. Individualized unit data will be distributed to the respective contributing sites. An overall anonymized report will be made available to contributing units. Results of the audit will be published in peer-reviewed journals with all collaborators fully acknowledged. The key information and results from the audit will be disseminated at relevant scientific meetings.

Bibliographic note

© The Author(s) 2019. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus.

Details

Original languageEnglish
Article numberdoz007
Number of pages15
JournalDiseases of the Esophagus
Volume33
Issue number1
Early online date19 Mar 2019
Publication statusPublished - Jan 2020

Keywords

  • anastomotic leak, esophagectomy, outcome assessment (health care), prospective study