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  • EuroSurg Collaborative  (14)
  • 1
    Online Resource
    Online Resource
    P130 Timing of nasogastric tube insertion and risk of postoperative pneumonia: international, prospective cohort study
    Oxford University Press (OUP) ; 2021
    In:  BJS Open Vol. 5, No. Supplement_1 ( 2021-04-08)
    Details
    In: BJS Open, Oxford University Press (OUP), Vol. 5, No. Supplement_1 ( 2021-04-08)
    Abstract: This study aims to assess whether Prophylactic NGT insertion was associated with reduced rates of pneumonia, in comparison to Reactive NGT after colorectal surgery. Methods Pre-planned secondary analysis of a multicentre, prospective cohort study. Patients undergoing elective colorectal surgery between January and April 2018 were included. Those receiving NGT were divided into three groups, based on the timing of the placement: Routine (at the time of surgery); Prophylactic (after surgery, before vomiting); and Reactive (after surgery, after vomiting). Pneumonia within 30 postoperative days was considered as primary outcome measure and it was compared between the three groups using multivariable regression analysis. Results 4,715 patients were included in the analysis. 1,536 (32.6%) received an NGT corresponding to 926 (60.3%) Routine, 461 (30%) Reactive and 149 (9.7%) Prophylactic. 200 patients (4.2%) developed pneumonia (No NGT: 2.7%; Routine NGT: 5.2%; Reactive NGT: 10.6%; Prophylactic NGT: 11.4%). After adjustment for confounding factors, no significant difference in pneumonia rates was detected between the Prophylactic and Reactive NGT groups (OR: 1.03, 95% CI: 0.56 – 1.87, p = 0.932). Conclusion In patients who required NGT insertion after surgery, prophylactic insertion was not associated with fewer cases of pneumonia within 30 days of surgery in comparison to reactive insertion.
    Type of Medium: Online Resource
    ISSN: 2474-9842
    URL: Article
    DOI: 10.1093/bjsopen/zrab032.129
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2902033-5
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  • 2
    Online Resource
    Online Resource
    Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery
    Oxford University Press (OUP) ; 2020
    In:  British Journal of Surgery Vol. 107, No. 2 ( 2020-01-05), p. e161-e169
    Details
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 107, No. 2 ( 2020-01-05), p. e161-e169
    Abstract: Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non-steroidal anti-inflammatory drugs (NSAIDs) for reducing ileus after surgery. Methods A prospective multicentre cohort study was delivered by an international, student- and trainee-led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a centre-specific survey of compliance to enhanced recovery principles. Secondary safety outcomes included anastomotic leak rate and acute kidney injury. Results A total of 4164 patients were included, with a median age of 68 (i.q.r. 57–75) years (54·9 per cent men). Some 1153 (27·7 per cent) received NSAIDs on postoperative days 1–3, of whom 1061 (92·0 per cent) received non-selective cyclo-oxygenase inhibitors. After adjustment for baseline differences, the mean time to gastrointestinal recovery did not differ significantly between patients who received NSAIDs and those who did not (4·6 versus 4·8 days; hazard ratio 1·04, 95 per cent c.i. 0·96 to 1·12; P = 0·360). There were no significant differences in anastomotic leak rate (5·4 versus 4·6 per cent; P = 0·349) or acute kidney injury (14·3 versus 13·8 per cent; P = 0·666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35·3 versus 56·7 per cent; P & lt; 0·001). Conclusion NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    URL: Article
    DOI: 10.1002/bjs.11326
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2006309-X
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  • 3
    Online Resource
    Online Resource
    IMAGINE: Ileus management international
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  International Journal of Surgery Vol. 55 ( 2018-07), p. S40-
    Details
    In: International Journal of Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 55 ( 2018-07), p. S40-
    Type of Medium: Online Resource
    ISSN: 1743-9191
    URL: Article
    DOI: 10.1016/j.ijsu.2018.05.171
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 2201966-2
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  • 4
    Online Resource
    Online Resource
    V1 Enhanced Recovery After Surgery (ERAS) compliance in elective colorectal surgery: an international multicentre survey
    Oxford University Press (OUP) ; 2021
    In:  BJS Open Vol. 5, No. Supplement_1 ( 2021-04-08)
    Details
    In: BJS Open, Oxford University Press (OUP), Vol. 5, No. Supplement_1 ( 2021-04-08)
    Abstract: ERAS protocols are widely endorsed after colorectal surgery. This study aims to describe compliance with the individual principles of ERAS across an international setting. Methods A hospital-level survey was administered. This aimed to describe hospital-level compliance to 17 principles of ERAS after elective colorectal surgery. The questionnaire was mandatory for all hospitals participating in an international cohort study on colorectal surgery between October 2017 and July 2018. Results A total of 422 hospitals took part in the cohort study and submitted questionnaires. Most hospitals (90%) were located in Europe. The overall median compliance was 14 out of 17 items. Only 13.7% of centres were compliant with all 17 items. High compliance was noted for items: patient counseling (91%); antibiotic prophylaxis (91.5%); venous thromboembolism prophylaxis (98.8%); early mobilization (97.2%); and avoidance of hypothermia (92.5%). Lower compliance was noted for items: preoperative oral carbohydrates (55.4%), standardized anesthesia protocol, (68.6%), early oral tolerance (69.8%), avoidance of abdominal drain (64.4%), and avoidance of mechanical bowel preparation (59.3%). Conclusion Overall compliance with ERAS guidelines was high however there is still scope for improvement. New strategies should be considered to attain full adherence to ERAS guidelines in the management of patients undergoing elective colorectal surgery.
    Type of Medium: Online Resource
    ISSN: 2474-9842
    URL: Article
    DOI: 10.1093/bjsopen/zrab034
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2902033-5
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  • 5
    Online Resource
    Online Resource
    Acute PresentatiOn of coLorectaL cancer ‐ an internatiOnal snapshot (APOLLO): Protocol for a prospective, multicentre cohort study
    Wiley ; 2023
    In:  Colorectal Disease Vol. 25, No. 1 ( 2023-01), p. 144-149
    Details
    In: Colorectal Disease, Wiley, Vol. 25, No. 1 ( 2023-01), p. 144-149
    Abstract: The primary aim of the study is to describe the variation in the operative and nonoperative management of emergency presentations of colon and rectal cancer in an international cohort. Secondary aims will be to develop a risk prediction model for mortality and primary anastomosis and validate risk criteria of large bowel obstruction (LBO) in patients with previously known colorectal cancer undergoing neoadjuvant chemotherapy or awaiting elective surgery. Method This prospective, multicentre audit will be conducted via the student‐ and trainee‐led EuroSurg Collaborative network internationally over 2023 with 90‐day follow‐up. Data will be collected on consecutive adult patients presenting to the hospital in an unplanned and urgent manner with colorectal cancer (CRC) due to malignant LBO, perforation, CRC‐related haemorrhage, or other related reasons. Primary outcome is 90‐day mortality. Secondary outcomes include rates of stomas, primary anastomosis, stenting, preoperative imaging, and complications or readmissions. Conclusion This protocol describes the methodology for the first international audit on the management of acutely presenting CRC. This study will utilise a large collaborative network with robust data validation and assurance strategies. APOLLO will provide a comprehensive understanding of current practice, develop risk prediction tools in this setting, and validate existing trial results.
    Type of Medium: Online Resource
    ISSN: 1462-8910 , 1463-1318
    URL: Issue
    URL: Article
    DOI: 10.1111/codi.v25.1
    DOI: 10.1111/codi.16464
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2004820-8
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  • 6
    Online Resource
    Online Resource
    Body mass index and complications following major gastrointestinal surgery: a prospective, international cohort study and meta‐analysis
    Wiley ; 2018
    In:  Colorectal Disease Vol. 20, No. 8 ( 2018-08)
    Details
    In: Colorectal Disease, Wiley, Vol. 20, No. 8 ( 2018-08)
    Abstract: Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a meta‐analysis of all available prospective data. Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end‐point was 30‐day major complications (Clavien–Dindo Grades III –V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta‐analysis was used to analyse pooled results. Results This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance ( P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta‐analysis demonstrated that obese patients undergoing surgery for malignancy were at increased risk of major complications ( OR 2.10, 95% CI 1.49–2.96, P 〈 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk ( OR 0.59, 95% CI 0.46–0.75, P 〈 0.001) compared to normal weight patients. Conclusions In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta‐analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease.
    Type of Medium: Online Resource
    ISSN: 1462-8910 , 1463-1318
    URL: Issue
    URL: Article
    DOI: 10.1111/codi.2018.20.issue-8
    DOI: 10.1111/codi.14292
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2004820-8
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  • 7
    Online Resource
    Online Resource
    Management of COMPlicAted intra‐abdominal collectionS after colorectal Surgery (COMPASS): protocol for a multicentre, observational, prospective international study of drain placement practices in colorectal surgery
    Wiley ; 2020
    In:  Colorectal Disease Vol. 22, No. 12 ( 2020-12), p. 2315-2321
    Details
    In: Colorectal Disease, Wiley, Vol. 22, No. 12 ( 2020-12), p. 2315-2321
    Abstract: Postoperative drains have historically been used for the prevention and early detection of intra‐abdominal collections. However, current evidence suggests that prophylactic drain placement following colorectal surgery has no significant clinical benefit. This is reflected in the enhanced recovery after surgery (ERAS) guidelines, which recommend against their routine use. The Ileus Management International study found more than one‐third of participating centres across the world routinely used drains in the majority of colorectal resections. The aim of the present study is to audit international compliance with ERAS guidelines regarding the use of postoperative drains in colorectal surgery. Method This prospective, multicentre audit will be conducted via the student‐ and trainee‐led EuroSurg Collaborative network across Europe, South Africa and Australasia. Data will be collected on consecutive patients undergoing elective and emergency colorectal surgery with 30‐day follow‐up. This will include any colorectal resection, formation of colostomy/ileostomy and reversal of stoma. The primary end‐point will be adherence to ERAS guidelines for intra‐abdominal drain placement. Secondary outcomes will include the following: time to diagnosis of intra‐abdominal postoperative collections; output and time to removal of drains; and 30‐day postoperative complications defined by the Clavien–Dindo classification. Conclusion This protocol describes the methodology for the first international audit of intra‐abdominal drain placement after colorectal surgery. The study will be conducted across a large collaborative network with quality assurance and data validation strategies. This will provide a clear understanding of current practice and novel evidence regarding the efficacy and safety of intra‐abdominal drain placement in colorectal surgical patients.
    Type of Medium: Online Resource
    ISSN: 1462-8910 , 1463-1318
    URL: Issue
    URL: Article
    DOI: 10.1111/codi.v22.12
    DOI: 10.1111/codi.15275
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2004820-8
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  • 8
    Online Resource
    Online Resource
    Safety of non-steroidal anti-inflammatory drugs after colorectal surgery: centre-level analysis of the IMAGINE study
    Oxford University Press (OUP) ; 2022
    In:  British Journal of Surgery Vol. 109, No. 6 ( 2022-05-16), p. 556-558
    Details
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 109, No. 6 ( 2022-05-16), p. 556-558
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    URL: Article
    DOI: 10.1093/bjs/znac066
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2006309-X
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  • 9
    Online Resource
    Online Resource
    Body mass index and complications following major gastrointestinal surgery: A prospective, international cohort study and individual patient data meta-analysis
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  International Journal of Surgery Vol. 55 ( 2018-07), p. S48-
    Details
    In: International Journal of Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 55 ( 2018-07), p. S48-
    Type of Medium: Online Resource
    ISSN: 1743-9191
    URL: Article
    DOI: 10.1016/j.ijsu.2018.05.214
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 2201966-2
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  • 10
    Online Resource
    Online Resource
    Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study
    Oxford University Press (OUP) ; 2022
    In:  British Journal of Surgery Vol. 109, No. 6 ( 2022-05-16), p. 520-529
    Details
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 109, No. 6 ( 2022-05-16), p. 520-529
    Abstract: Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien–Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P & lt; 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P & lt; 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    URL: Article
    DOI: 10.1093/bjs/znac069
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2006309-X
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