ESCP leadThe ESCP Safe-anastomosis Programme in Colorectal Surgery (EAGLE) is an international, multi-centre, cluster randomised-sequence service improvement study of the ESCP Safe-anastomosis Quality Improvement Intervention to reduce anastomotic leak following right colectomy and ileocaecal resection. Any hospital or surgical unit performing elective and/or emergency colorectal surgery may participate.

The study consists of interactive, online training modules for surgeons and theatre teams and will assess whether implementation of the ESCP safe-anastomosis intervention reduces risk of anastomotic leak rate.

The study programme has three main approaches:

  • Preoperative risk stratification - making sure for each patient that anastomosis is safe for them
  • Harmonisation of surgical technique - making the best anastomosis possible and checking it carefully after it is created
  • Implementation of an intra-operative, anastomosis ‘checklist’ - focusing the attention of the whole theatre team at this critical stage of the operation.

Overall, we hope to reach out to more than 2,000 surgeons in over 300 hospitals across the world, including 4,500 patients in total.

The primary outcome is the 30-day overall anastomotic leak rate, defined as clinical or radiologically detected anastomotic leak or intra-abdominal or pelvic collection.

Latest News - December 2023

The EAGLE study is now complete and was delivered across 355 hospitals in 64 countries. More than 3,000 patients were entered into the study and more than 2,000 surgeons from across the world completed the EAGLE educational training modules. The study has been published in the British Journal of Surgery (BJS) and can be viewed at

The EAGLE training platform is now available free of charge for surgeons around to world to use. You can access it at

Graphic showing the process of the EAGLE study

Further information

You can find out more about EAGLE and how to get involved, online at where you can access the Site Set-up Pathway which is now live. We have a team of 22 coordinators ready to help support hospitals in setting up their sites for EAGLE.

ESCP Vienna 2019 videos

ESCP held a satellite symposium 'Reducing Anastomotic Leaks - the EAGLE has landed' at our conference in Vienna 2019. Videos of this session are freely-accessible to view:


Download our EAGLE Newsletters for study updates and information:

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