ReviewJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2013
Do we really know why colorectal anastomoses leak?
Review in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 135 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
135 citing papers in PubMed, 9 syntheses or guidelines pooled it, 231 citations in OpenAlex.
- A meta-analysis of the effects of preoperative mechanical intestinal preparation and oral antibiotics on surgical site infection after rectal tumor resection.Updates in surgery · 2026Pooled it
- Mechanical bowel preparation combined with oral antibiotics reduces infectious complications and anastomotic leak in elective colorectal surgery: a pooled-analysis with trial sequential analysis.International journal of colorectal disease · 2023Pooled it
- Endoscopic Treatment Options for Gastrointestinal Leaks.Visceral medicine · 2022Pooled it
- Matrix metalloproteinase-9 in relation to patients with complications after colorectal surgery: a systematic review.International journal of colorectal disease · 2021Pooled it
- The impact of transanal tube design for preventing anastomotic leak in anterior resection: a systematic review and meta-analysis.Techniques in coloproctology · 2021Pooled it
- Failure of enhanced recovery after surgery in laparoscopic colorectal surgery: a systematic review.International journal of colorectal disease · 2020Pooled it
- Is a drain necessary after anterior resection of the rectum? A systematic review and meta-analysis.International journal of colorectal disease · 2019Pooled it
- The application of defunctioning stomas after low anterior resection of rectal cancer.Surgery today · 2019Pooled it
- Transanal Tube for the Prevention of Anastomotic Leakage After Rectal Cancer Surgery: A Systematic Review and Meta-analysis.World journal of surgery · 2017Pooled it
- Comparison of two bundles for reducing surgical site infection in colorectal surgery: multicentre cohort study.BJS open · 2024Trial
- Prevention of anastomotic leak in rectal cancer surgery with local antibiotic decontamination: a prospective, randomized, double-blind, placebo-controlled single center trial.International journal of colorectal disease · 2020Trial
- Ileostomy reversal with handsewn techniques. Short-term outcomes in a teaching hospital.International journal of colorectal disease · 2017Trial
- Patient's weight-based indocyanine green dose for fluorescence angiography with led imaging system in left-sided colorectal resections.Surgical endoscopy · 2026Article
- Impact of intraoperative colonoscopy for anastomosis assessment after left-sided colorectal surgery: a meta-analysis.Surgery today · 2026Article
- Impact of powered circular stapling devices on anastomotic leakage rates in colorectal surgery.International journal of colorectal disease · 2026Article
- Intraoperative Multimodal Bowel Perfusion Quantification Combining Hyperspectral Imaging and Indocyanine Green.Diagnostics (Basel, Switzerland) · 2026Article
- The effect of vaping and smoking on colonic anastomosis healing in an experimental animal model.Scientific reports · 2026Article
- Understanding Anastomotic Healing in Colo-Rectal Surgery; a Multicentric 5-Year Analysis of Predictive Factors for Integrity and Fistula Formation.Diagnostics (Basel, Switzerland) · 2026Article
- Recurrent Anastomotic Leak After Hartmann Reversal: Successful Management With Vacuum-Assisted Endoscopic Drainage and Diversion.ACG case reports journal · 2026Article
- A landmark-based dynamic prediction model for anastomotic leakage after rectal cancer surgery: integrating perioperative and postoperative trajectories.Frontiers in oncology · 2026Article
75 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionColorectal anastomotic leak, a feared complication, results in significantly increased patient morbidity, mortality, and hospital resource utilization. The overall incidence of colorectal anastomotic leak is approximately 11% with increasing rate the closer the anastomosis is to the anal verge. Because surgeons are unable to reliably predict which anastomosis would fail, most will construct a diverting ileostomy for low colorectal anastomosis to circumvent the devastating complications of anastomotic failure. Despite extensive investigations on technical considerations of anastomosis construction, anastomotic leaks continue to occur at an unacceptably high rate. DISCUSSION: In this review, we examine the major known risk factors and technical considerations that have been implicated as factors in leakage. Although surgical technique has evolved over the past several decades with the advent of newer surgical staplers, laparoscopy, and robotics, we have not witnessed a decrease in the incidence of colorectal anastomotic leaks suggesting that the fundamental pathogenesis of anastomotic leak remains unknown. Among the factors contributing to anastomotic healing, intestinal bacteria remains largely overlooked even though compelling evidence exist that intraluminal microbes could play a major role in pathogenesis of anastomotic leak. Further investigation focusing on intestinal microbes could be one such avenue for uncovering the elusive cause of colorectal anastomotic leak.
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Registered trials
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.