eP818 - The Implementation Of The Mobile Application "Colorectal Leakage App" For Early Detection Of Anastomotic Leakage After Colorectal Surgeries.

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Purpose/Background: To evaluate the effectiveness of the mobile application "Colorectal Leakage App" in the early diagnosis of anastomotic leakage after colorectal surgeries.
Objectives of the study:
1. Development, validation, and implementation of the mobile application "Colorectal Leakage App," based on the Dutch Leakage Score.
2. Evaluate the diagnostic effectiveness of the application in detecting of anastomotic leakage after colorectal surgeries.
3. Determine the frequency of anastomotic leakage after colorectal surgeries performed in the colorectal surgery division of the National Research Oncology Center in Astana city Kazakhstan.Methods/Interventions: Prospective observational study, where the "Colorectal Leakage App" mobile application will be implemented in daily postoperative monitoring and its diagnostic effectiveness will be assessed.

The "Colorectal Leakage App" is a mobile application that, based on an algorithm, provides an assessment of the risk of Anastomotic Leakage (AL) in patients after colorectal surgeries. The algorithm is built on the standardized postoperative monitoring protocol called "Dutch Leakage Score" (Table 1). After calculating the scores, the application provides recommendations for further actions (Scheme 1).

Postoperative monitoring with the "Colorectal Leakage App":
It is planned to implement standardized postoperative monitoring for patients who have undergone colorectal surgeries using the "Colorectal Leakage App." The application will include an algorithm based on the Dutch Leakage Score indicator. Each postoperative day, data entry at the patient's bedside will be carried out in the application.
a) Fever
b) Heart rate
c) Respiratory rate
d) Urinary production
e) Mental status
f) Clinical condition
g) Signs of ileus
h) Gastric retention
i) Fascial dehiscence
j) Abdominal pain, other than
k) wound pain
l) Increased leukocyte count, C-reactive protein (CRP), creatinine, and urea.
m) Nutritional status
Based on the data analysis, the algorithm will provide recommendations regarding the necessity of conducting a computer tomography with rectal contrast (Scheme 1).Results/Outcomes: Primary endpoints:
1. Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value.
2. Frequency of AL after colorectal surgeries
Secondary endpoints:
1. Mortality within 30 days:.
2. Delay in the diagnosis of AL (number of days from the onset of the first signs of a leakage to the diagnosis of AL)
3. Duration of hospital stay.
4. Number of days in the ICU.
5. Number of days between surgery and detection of AL.Conclusion/

Discussion: In this prospective observational study, we aim to assess the effectiveness of the mobile application "Colorectal Leakage App" in the early detection of AL after colorectal surgeries. The study will be conducted at the National Research Oncology Center (NROC) in Astana, Kazakhstan, over one year. The primary goal is to evaluate the diagnostic effectiveness of the application in detecting AL after colorectal surgeries.
We hypothesize that this application will be highly beneficial in developing countries. Therefore, after validating the application in our center, we are planning to conduct a prospective randomized multicenter trial involving low- and medium-volume centers.Table 1Items of Dutch leakage score.Scheme 1Algorithm for assessing anastomotic leakage, indicating actions to be taken for each result. Clinically proven Anastomotic Leakage (fecal discharge in drainage or wound) is treated identically to confirmed Anastomotic Leakage on CT scan. AL - Anastomotic Leakage. CT - Computed Tomography.