Study protocol for a multicenter prospective cohort study on esophagogastric anastomoses and anastomotic leak (the Oesophago-Gastric Anastomosis Audit/OGAA)

Evans, Richard; Singh, Pritam; Nepogodiev, Dmitri; Bundred, James; Kamarajah, Sivesh K.; Jefferies, B; Siaw-Acheampong, K; Wanigasooriya, Kasun; McKay, Siobhan C.; Imran, Mohamed; Whitehouse, Tony; Alderson, Derek; Gossage, James; Hillegersberg, Richard van; Vohra, Ravinder; Griffiths, Ewen

doi:10.1093/dote/doz007

Cited by 17 publications

(18 citation statements)

References 34 publications

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“…All endeavours were made to ensure open and inclusive centre recruitment, to provide a comprehensive global cohort. The protocol for this study has been published 12 , 13 along with the collaborative model that has successfully delivered a number of international and national cohort studies 14–17 .…”

Section: Methodsmentioning

confidence: 99%

Comparison of short-term outcomes from the International Oesophago-Gastric Anastomosis Audit (OGAA), the Esophagectomy Complications Consensus Group (ECCG), and the Dutch Upper Gastrointestinal Cancer Audit (DUCA)

Kamarajah¹,

Nepogodiev²,

Bundred³

et al. 2021

BJS Open

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Background The Esophagectomy Complications Consensus Group (ECCG) and the Dutch Upper Gastrointestinal Cancer Audit (DUCA) have set standards in reporting outcomes after oesophagectomy. Reporting outcomes from selected high-volume centres or centralized national cancer programmes may not, however, be reflective of the true global prevalence of complications. This study aimed to compare complication rates after oesophagectomy from these existing sources with those of an unselected international cohort from the Oesophago-Gastric Anastomosis Audit (OGAA). Methods The OGAA was a prospective multicentre cohort study coordinated by the West Midlands Research Collaborative, and included patients undergoing oesophagectomy for oesophageal cancer between April and December 2018, with 90 days of follow-up. Results The OGAA study included 2247 oesophagectomies across 137 hospitals in 41 countries. Comparisons with the ECCG and DUCA found differences in baseline demographics between the three cohorts, including age, ASA grade, and rates of chronic pulmonary disease. The OGAA had the lowest rates of neoadjuvant treatment (OGAA 75.1 per cent, ECCG 78.9 per cent, DUCA 93.5 per cent; P < 0.001). DUCA exhibited the highest rates of minimally invasive surgery (OGAA 57.2 per cent, ECCG 47.9 per cent, DUCA 85.8 per cent; P < 0.001). Overall complication rates were similar in the three cohorts (OGAA 63.6 per cent, ECCG 59.0 per cent, DUCA 62.2 per cent), with no statistically significant difference in Clavien–Dindo grades (P = 0.752). However, a significant difference in 30-day mortality was observed, with DUCA reporting the lowest rate (OGAA 3.2 per cent, ECCG 2.4 per cent, DUCA 1.7 per cent; P = 0.013). Conclusion Despite differences in rates of co-morbidities, oncological treatment strategies, and access to minimal-access surgery, overall complication rates were similar in the three cohorts.

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Section: Methodsmentioning

confidence: 99%

Comparison of short-term outcomes from the International Oesophago-Gastric Anastomosis Audit (OGAA), the Esophagectomy Complications Consensus Group (ECCG), and the Dutch Upper Gastrointestinal Cancer Audit (DUCA)

Kamarajah¹,

Nepogodiev²,

Bundred³

et al. 2021

BJS Open

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“…Thus, information from this study is useful as it can help shape the future direction of research into POPF. An ongoing international multicentre collaborative study of anastomotic leaks following oesophagectomy, 127,128 has helped derive novel data, by way of example. Establishing a framework for the collection of prospective multicentre, multi‐national data within registries would permit evaluation of factors across geographic and organizational boundaries and enable novel study design such as Trials Within Cohort (TWiC) studies 3–5,7,129–131 .…”

Section: Discussionmentioning

confidence: 99%

Systematic review and meta‐analysis of factors associated with post‐operative pancreatic fistula following pancreatoduodenectomy

Kamarajah

Bundred

Lin

et al. 2020

ANZ Journal of Surgery

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Background Many studies have explored factors relating to post‐operative pancreatic fistula (POPF); however, the original definition (All‐POPF) was revised to include only ‘clinically relevant’ (CR) POPF. This study identified variables associated with the two International Study Group on Pancreatic Surgery definitions to identify which variables are more strongly associated with CR‐POPF. Methods A systematic review identified all studies reporting risk factors for POPF (using both International Study Group on Pancreatic Fistula definitions) following pancreatoduodenectomy. The primary outcome was factors associated with CR‐POPF. Meta‐analyses (random effects models) of pre‐, intra‐ and post‐operative factors associated with POPF in more than two studies were included. Results Among 52 774 patients All‐POPF (n = 69 studies) and CR‐POPF (n = 53 studies) affected 27% (95% confidence interval (CI95%) 23–30) and 19% (CI95% 17–22), respectively. Of the 176 factors, 24 and 17 were associated with All‐ and CR‐POPF, respectively. Absence of pre‐operative pancreatitis, presence of renal disease, no pre‐operative neoadjuvant therapy, use of post‐operative somatostatin analogues, absence of associated venous or arterial resection were associated with CR‐POPF but not All‐POPF. Conclusion In conclusion this study demonstrates wide variation in reported rates of POPF and that several risk factors associated with CR‐POPF are not used within risk prediction models. Data from this study can be used to shape future studies, research and audit across ethnic and geographic boundaries in POPF following pancreatoduodenectomy.

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“…An example of this relates to the prevention of anastomotic leaks in OG cancer surgery. This question is being addressed in the Oesophagogastric anastomosis audit (OGAA) study (25). The outcome of the ROMIO (26) study should also help to determine the best predictors of long term survival following oesophagectomy.…”

Section: Discussionmentioning

confidence: 99%

A modified Delphi process to establish future research priorities in malignant oesophagogastric surgery

et al. 2020

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The version presented here may differ from the published version. If citing, you are advised to consult the published version for pagination, volume/issue and date of publication A modified Delphi process to establish future research priorities in malignant oesophagogastric surgery Abstract Background With rapid advancement in the genomics of oesophagogastric (OG) cancer and raised expectations in clinical outcomes from patients and clinicians alike there is a clear need to determine the current research priorities in OG cancer surgery. The aim of our study was to use a modified Delphi process to determine the research priorities among OG cancer surgeons in the United Kingdom. Methods Delphi methodology may be utilised to develop consensus opinion amongst a group of experts. Members of the Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland were invited to submit individual research questions via an online survey (phase I). Two rounds of prioritisation by multidisciplinary expert healthcare professionals (phase II and III) were completed to determine a final list of high priority research questions. ResultsIn total, 427 questions were submitted in phase I and 75 with an OG cancer focus were taken forward for prioritisation in phase II. Phase III produced a final list of 12 high priority questions with an emphasis on tailored or personalised treatment strategies in OG cancer surgery. ConclusionA modified Delphi process produced a list of 12 high priority research questions in OG cancer surgery. Future studies and awards from funding bodies should reflect this consensus list of prioritised questions in the interest of improving patient care and encouraging collaborative research across multiple centres.

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Study protocol for a multicenter prospective cohort study on esophagogastric anastomoses and anastomotic leak (the Oesophago-Gastric Anastomosis Audit/OGAA)

Cited by 17 publications

References 34 publications

Comparison of short-term outcomes from the International Oesophago-Gastric Anastomosis Audit (OGAA), the Esophagectomy Complications Consensus Group (ECCG), and the Dutch Upper Gastrointestinal Cancer Audit (DUCA)

Comparison of short-term outcomes from the International Oesophago-Gastric Anastomosis Audit (OGAA), the Esophagectomy Complications Consensus Group (ECCG), and the Dutch Upper Gastrointestinal Cancer Audit (DUCA)

Systematic review and meta‐analysis of factors associated with post‐operative pancreatic fistula following pancreatoduodenectomy

A modified Delphi process to establish future research priorities in malignant oesophagogastric surgery

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