Evidence map›Paper›PMID 25743996›Full record

SynthesisSurgical endoscopy2015

Clinical risk factors for anastomotic leakage after laparoscopic anterior resection for rectal cancer: a systematic review and meta-analysis.

Hui Qu, Yao Liu, Dong-song Bi

Registry-linked trialAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03013153 (Low or High Ligation of the Inferior Mesenteric Artery With Apical Lymph Node Dissection in Rectal Cancer Laparoscopic Surgery), which is not on this map. Cited by 157 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
157citing papers in PubMed, 14 pooled it
6.2field-weighted citation impact, top 2% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT03013153 naunknown statusnot on this mapstarted 2016, after this paper: background citation

Low or High Ligation of the Inferior Mesenteric Artery With Apical Lymph Node Dissection in Rectal Cancer Laparoscopic Surgery: A Prospective, Multi-Center, Randomized, Open-Label, Parallel Group, Non-Inferiority Clinical Trial (LAND)

TypeinterventionalSponsorSixth Affiliated Hospital, Sun Yat-sen UniversityRan2016 to 2023Enrolled748ConditionsRectal CancerArmsLow ligation with apical lymph node dissection, High ligation
3 · Its place in the literature

Who cites it

157 citing papers in PubMed, 14 syntheses or guidelines pooled it, 282 citations in OpenAlex.

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  9. Intraluminal Anastomotic Assessment Using Indocyanine Green Near-Infrared Imaging for Left-Sided Colonic and Rectal Resections: a Systematic Review.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023
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97 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

Hui QuDepartment of General Surgery, Shandong University Qilu Hospital, No.107 of the West Cultural Road, Jinan, 250012, Shandong, China. doctorquhui@126.com.
Yao LiuDepartment of Respiratory Medicine, Provincial Hospital Affiliated to Shandong University, Jinan, China.
Dong-song BiDepartment of General Surgery, Shandong University Qilu Hospital, No.107 of the West Cultural Road, Jinan, 250012, Shandong, China. 18560085120@163.com.
Qilu Hospital of Shandong University · CNShandong University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAnastomotic leakage (AL) is a serious complication in laparoscopic rectal cancer surgery, and risk factors for AL are not well defined. Herein, we conducted a systematic review to quantify the clinicopathologic factors predictive for AL in patients who underwent laparoscopic anterior resection (LAR) for rectal cancer.

methodsA systematic search of electronic databases (PubMed, Embase, Cochrane CENTRAL, Scopus Database, and Wanfang Database) for studies published until August 2014 was performed. Cohort, case-control studies, and randomized controlled trials that examined clinical risk factors for AL were included.

resultsFourteen studies (seven prospective and seven retrospective studies) involving 4580 patients met final inclusion criteria. From the pooled analyses, five demographic factors were found to be significantly associated with the development of AL, including male gender (OR 2.04, 95% CI 1.50-2.77), BMI ≥25 kg/m(2) (OR 1.46, 95% CI 1.00-2.14), ASA score >2 (OR 1.74, 95% CI 1.04-2.93, P = 0.04), tumor size >5 cm (OR 1.63, 95% CI 1.01-2.64, P = 0.05), and preoperative chemotherapy (OR 1.67, 95% CI 1.10-2.55, P = 0.02). Four operative factors were significantly associated with increased risk of AL, including longer operative time (95% CI 1.71-5.77, P = 0.0002), number of stapler firings ≥3 (OR 0.17, 95% CI 0.07-0.41, P < 0.001), intra-operative transfusions/blood loss >100 mL (OR 3.79, 95% CI 2.48-5.49, P < 0.001), and anastomosis level within 5 cm from the anal verge (OR 9.63, 95% CI 3.05-30.43, P = 0.0001), while pelvic drain (OR 0.43, 95% CI 0.19-0.94, P = 0.04) was significantly associated with a lower AL rate.

conclusionOur analysis identified several clinicopathologic factors associated with AL in patients who underwent LAR. The knowledge of these risk factors may influence treatment- and procedure-related decisions and possibly reduce the leakage rate.

Indexed as

Risk AssessmentAnal CanalAnastomosis, SurgicalAnastomotic LeakColectomyGlobal HealthHumansLaparoscopyRectal NeoplasmsRisk FactorsCancerClinical endoscopyClinical researchClinical trialsColorectal < clinical papers

Identifiers

PMID25743996
OpenAlexW1996328494

What OpenQuestion holds

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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.