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Cola

Michel Adamina, Prof. Dr. med.

Anas Taha, Dr. med.

Thomas Steffen

Stephanie Taha-Mehlitz, Dr. med.

Frédéric Ris, Prof. Dr. med.

The Prediction of Anastomotic Insufficiency risk after Colorectal surgery (PANIC) study aims to establish a machine-learning-based application that allows for accurate preoperative prediction of patients at risk for anastomotic insufficiency after colon and colorectal surgery.

Anastomotic insufficiency leads to clinical strains for patients, and significantly increases morbidity and mortality. On average, hospital stay is extended by 12 days while healthcare-related expenses are increased by 30,000 USD when patients suffer from an anastomotic leak. In experienced centers, the approximated incidence of anastomotic insufficiency is 3,3% for colon and 8.6% for colorectal procedures. Multiple subgroups of patients with increased risk for anastomotic leaks have been described in previous publications. Meticulous preoperative recognition of patients with increased risk for anastomotic insufficiency is clinically beneficial, as it would permit improved ressource preparation, enhanced patient education and superior surgical decision-making. However, it is often difficult for clinicians to balance the plethora of crucial risk factors for anastomotic leaks for a single patient. Machine learning methods have been exceptionally effective at incorporating various clinical variables into one unified risk prediction model. To the authors' best knowledge, there does not yet exist a credible prediction model or a conclusive prediction score for anastomotic insufficiency after colon and colorectal anastomosis. The aim of the Prediction of Anastomotic Insufficiency risk after Colorectal surgery (PANIC) study is to establish and externally validate an efficient machine-learning-based prediction tool based on multicenter data from a range of international centers.

The Prediction of Anastomotic Insufficiency Risk After Colorectal Surgery (PANIC) Study

The Prediction of Anastomotic Insufficiency Risk After Colorectal Surgery (PANIC) Study: Development and External Validation of an International, Multicenter Machine Learning Algorithm for Prediction of Anastomotic Insufficiency After Colonic or Colorectal Anastomosis

Did the patient receive adjuvant/additive immunochemotherapy after surgery? (yes/no)

Did the patient receive adjuvant/additive radiotherapy after surgery? (yes/no)

Did the patient receive additive curative surgery after the initial intervention? (no/yes: liver; lung; locoragional relapse)

Occurrence of anastomotic insufficiency/leak is defined as any clinical signs of leakage, confirmed by radiological examination, endoscopy, clinical examination of the anastomosis, or upon reoperation.

Time to diagnosis of a leakage will be calculated as days between the index operation and diagnosis of the leakage by imaging with extraluminal contrast, endoscopy, re-operation, or when fecal containing fluid is objectified in a drainage.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
The Prediction of Anastomotic Insufficiency Risk After Colorectal Surgery (PANIC) Study	NCT04985981	Anastomotic Lea... Colorectal Canc... Diverticulosis Crohn Disease Ulcerative Coli... Mesenteric Isch...		18 Years -	Kantonsspital Winterthur KSW
The Prediction of Anastomotic Insufficiency Risk After Colorectal Surgery (PANIC) Study	NCT04985981	Anastomotic Lea... Colorectal Canc... Diverticulosis Crohn Disease Ulcerative Coli... Mesenteric Isch...		18 Years -	Kantonsspital Winterthur KSW

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