The RECON (REspiratory ComplicatiOns after abdomiNal surgery) study was a prospective multicentre international audit designed and led by STARSurg in the United Kingdom ran from January to April 2019. We were looking to explore the common complication of post-operative pulmonary complications (PPCs) following major abdominal surgery. We planned to explore associations with increased morbidity, mortality and length of hospital stay.

The Royal College of Anaesthetists and Enhanced Recovery After Surgery (ERAS) guidelines provide pre-, intra- and post-operative measures to reduce the risk of PPCs. We set our study aims to explore the incidence of PPCs following major abdominal and incisional hernia surgery and secondarily to (1) evaluate adherence to perioperative measures to reduce the risk of PPCs; (2) establish risk factors for development of PPCs.

The study was immensely successful with 11,251 patients included in the final dataset, the largest for a STARSurg project to date. Key findings of the current analyses are as follows:

• The national adjusted PPC rate was 7.5%
  • Substantial variation was seen across all specialties ranging from 3.0% (n = 60/1983) in gynaecological to 17.4% (n = 136/668) in Upper GI procedures.

There is further analysis of the RECON dataset occurring with aims to explore:

• Associations between interventions and PPC rates.
• Variations in specialty specific PPC rates.
• Measures to be introduced as a cost-effective effort to reduce PPCs.