Towards safer colorectal surgery worldwide: outcomes and benchmarks from the ESCP CORREA 2022 audit

Salmi, Mohamad Irfan and Md Nor, Azmi and Elagili, Faisal and Sainal, Mohd. Yusof (2025) Towards safer colorectal surgery worldwide: outcomes and benchmarks from the ESCP CORREA 2022 audit. Colorectal Disease, 27 (11). pp. 1-20. ISSN 1462-8910 E-ISSN 1463-1318

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Abstract

Abstract 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 highlight the ongoing need for targeted research and quality-improvement initiatives to reduce anastomotic failure and improve outcomes of colorectal surgery.

Item Type:	Article (Journal)
Uncontrolled Keywords:	anastomotic leak, benchmarking, colorectal resection, enhanced recovery programme, ESCP audit,minimally invasive surgery, perioperative management, postoperative morbidity, prospective multicentre audi
Subjects:	R Medicine > RD Surgery
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine > Department of Surgery
Depositing User:	Asst Prof Faisal Elagili
Date Deposited:	03 Dec 2025 12:55
Last Modified:	03 Dec 2025 12:55
Queue Number:	2025-11-Q299
URI:	http://irep.iium.edu.my/id/eprint/124821

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