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 – January 2022

334 sites from across 65 different countries have been randomised to take part in EAGLE so far. Logins to the EAGLE safe-anastomosis modules have been issued to 3200 surgeons and trainees with 2000 already having accessed the modules. Almost 2500 patients from 250 hospitals have been entered into the study.

The next EAGLE randomisation will take place in February/March 2022. To register your site and find out more please visit, EAGLE is still recruiting new sites! Due to the success of the study we are aiming to recruit an additional 50 hospitals from across the world to take part, join today!

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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