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 – September 2022

EAGLE is now closed to recruitment of new hospitals. Interim study findings will be presented at the upcoming ESCP Congress in Dublin this month and early publications are being planned for 2023.

371 sites from across 65 different countries were randomised to take part in EAGLE . Logins to the EAGLE safe-anastomosis modules have been issued to >4000 surgeons and trainees with >2000 already having accessed the modules. Almost 3500 patients from 320 hospitals have been entered into the study, with data collection due to complete at the end of 2022.

The trial protocol has been published in Colorectal Disease and can be viewed at:

EAGLE Countries up to and including Phase 12

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:


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