ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2012
Influence of neoadjuvant radiotherapy on anastomotic leak after restorative resection for rectal cancer.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Preoperative risk factors associated with anastomotic leakage after colectomy for colorectal cancer: a systematic review and meta-analysis.Revista do Colegio Brasileiro de Cirurgioes · 2022Pooled it
- Prophylactic transanal decompression tube versus non-prophylactic transanal decompression tube for anastomotic leakage prevention in low anterior resection for rectal cancer: a meta-analysis.Surgical endoscopy · 2017Pooled it
- Outcomes of Neoadjuvant Radiotherapy Followed by Robotic Radical Prostatectomy in High-Risk Locally Advanced Prostate Cancer: A Prospective Pilot Study.Annals of surgical oncology · 2026Article
- Observational
- Anastomotic leakage in colorectal cancer surgery in Syria: risk factors and improvements following guideline implementation - a retrospective cohort study.Annals of medicine and surgery (2012) · 2026Article
- The effect of neoadjuvant chemoradiotherapy on perioperative outcomes in rectal cancer patients following stoma reversal-a retrospective cohort analysis.Journal of gastrointestinal oncology · 2025Article
- Effects of Neoadjuvant Radiotherapy on Postoperative Complications in Rectal Cancer: A Meta-Analysis.Journal of oncology · 2022Article
- Defining Anastomotic Leak and the Clinical Relevance of Leaks.Clinics in colon and rectal surgery · 2021Review
- Risk Factors for Anastomotic Leak, Consideration for Proximal Diversion, and Appropriate Use of Drains.Clinics in colon and rectal surgery · 2021Review
- A nomogram for predicting rectovaginal fistula after low anterior resection for rectal cancer.Surgery today · 2020Article
- The REAL (REctal Anastomotic Leak) score for prediction of anastomotic leak after rectal cancer surgery.Techniques in coloproctology · 2019Article
- Heparan Sulfate Mimetics: A New Way to Optimize Therapeutic Effects of Hydrogel-Embedded Mesenchymal Stromal Cells in Colonic Radiation-Induced Damage.Scientific reports · 2019Article
- Anastomotic Failure in Colorectal Surgery: Where Are We at?The Indian journal of surgery · 2018Review
- Adipose-Derived Mesenchymal Stromal Cells Improve the Healing of Colonic Anastomoses Following High Dose of Irradiation Through Anti-Inflammatory and Angiogenic Processes.Cell transplantation · 2017Article
- Temporary Diverting Stoma Improves Recovery of Anastomotic Leakage after Anterior Resection for Rectal Cancer.Scientific reports · 2017Article
- Diverting ileostomy in colorectal surgery: when is it necessary?Langenbeck's archives of surgery · 2015Review
- Does Preoperative Radio(chemo)therapy Increase Anastomotic Leakage in Rectal Cancer Surgery? A Meta-Analysis of Randomized Controlled Trials.Gastroenterology research and practice · 2014Review
- Do we really know why colorectal anastomoses leak?Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2013Review
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThis study was undertaken to determine whether neoadjuvant radiotherapy is associated with an increased risk of anastomotic leak for rectal cancer patients undergoing restorative resection.
methodsFrom 1980 to 2010, patients who underwent restorative resection for rectal cancer (tumors within 15 cm of anal verge) were identified from a prospective institutional database and grouped based on whether they received neoadjuvant radiotherapy (+RT) or not (-RT). The main outcome was anastomotic leak documented by imaging (contrast leak), intra-operative or clinical (signs of peritonitis) findings and confirmed by staff surgeon assessment. Using multivariate (MV) analysis risk factors for leak were identified, presented as OR (95 % CI).
resultsOne thousand eight hundred sixty-two patients were included in the analysis, 28 % in the +RT group. Eighty-six percent of +RT patients received neoadjuvant chemoradiotherapy. The overall leak rate was 6.3 %, with no significant difference in +RT and -RT groups (8 % vs 5.7 %, p = 0.06). The +RT group had a lower mean age at surgery (58 vs 63 year, p < 0.001), more male (75 % vs 62 %, p < 0.001) and more ASA 3/4 (44 % vs 35 %, p < 0.001) patients, greater use of defunctioning ostomy (87 % vs 44 %, p < 0.001) and colo-anal anastomosis (77 % vs 34 %, p < 0.001). Mean tumor distance from the anal verge was lower in +RT group (6.6 vs 9.7 cm, p < 0.001). On MV analysis, male sex (OR 1.64 (1.03-2.62), p = 0.038), ASA 4 (OR 4.70 (2.07-10.7), p < 0.001), tumor distance from anal verge ≤ 5 cm (OR 2.49 (1.37-4.52), p = 0.003), and tumor size at surgery ≥ 4 cm (OR 1.75 (1.15-2.65), p = 0.009) were independently associated with leak. +RT was not independently associated with leak (OR 1.44 (0.85-2.46), p = 0.18), while defunctioning ostomy did not reduce leak occurrence (OR 0.75 (0.44-1.28), p = 0.29).
conclusionsThe findings suggest that neoadjuvant radiotherapy is not independently associated with an anastomotic leak for rectal cancer patients undergoing restorative resection and support a selective policy towards the use of a defunctioning ostomy on a case by case basis based on intra-operative judgment and consideration of tumor location, size, and patient characteristics.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.