SynthesisInternational journal of colorectal disease2015
Utility of contrast enema to assess anastomotic integrity and the natural history of radiological leaks after low rectal surgery: systematic review and meta-analysis.
Synthesis in International journal of colorectal disease, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 46 citations in OpenAlex.
- Diagnostic value of CT scan findings for anastomotic leakage after low anterior resection without ileostomy in rectal cancer.Scientific reports · 2025Article
- Drain fluid iodine as a biomarker of anastomotic leak after low anterior resection in patients undergoing Gastrografin rectal tube flushes and omission of a diverting ileostomy: The GUSH study.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025Observational
- GI and GU fluoroscopy in common post-op oncologic surgeries: what you need to know about this leaky business!Abdominal radiology (New York) · 2025Review
- Bananagram: an alternative to distal loopogram prior to colostomy closure for Hirschsprung disease.World journal of pediatric surgery · 2025Article
- [Postoperative Imaging Findings of Colorectal Surgery: A Pictorial Essay].Journal of the Korean Society of Radiology · 2024Review
- CT scan for early diagnosis of anastomotic leak after colorectal surgery: is rectal contrast useful?Techniques in coloproctology · 2023Article
- MRI diagnose post-operative anastomotic leak in patients with rectal cancer: preliminary experience.BMC surgery · 2022Article
- A development study of drain fluid gastrografin as a biomarker of anastomotic leak.Annals of coloproctology · 2022Article
- Treatment Modalities for Anastomotic Leakage in Rectal Cancer Surgery.Clinics in colon and rectal surgery · 2021Review
- Less is more-the best test for anastomotic leaks in rectal cancer patients prior to ileostomy reversal.International journal of colorectal disease · 2021Review
- Out of the Loop: The Value of a Preoperative Loopogram for Colostomy Reversal in Trauma.World journal of surgery · 2021Article
- Review
- Is water-soluble contrast enema examination for integrity of rectal anastomosis necessary prior to ileostomy reversal?JGH open : an open access journal of gastroenterology and hepatology · 2020Article
- Radiological findings in anastomotic leakage after anterior resection may predict a permanent stoma.Acta radiologica open · 2020Article
- Before and after Anorectal Surgery: Which Information Is Needed from the Functional Laboratory?Visceral medicine · 2018Review
- Considerations in Stoma Reversal.Clinics in colon and rectal surgery · 2017Review
- Management of Colorectal Anastomotic Leak.Clinics in colon and rectal surgery · 2016Review
- Should a Contrast Enema Be Performed Before Reversal of a Diverting Stoma in Lower Rectal Surgery?Annals of coloproctology · 2015Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThere is no clear consensus on how to assess low rectal anastomotic integrity and patency prior to reversal of de-functioning stoma. The aim of this systematic review was to assess the utility of contrast enema (CE) in this context and to clarify the natural history of radiological leaks.
methodsKeyword search of electronic databases (Embase, MEDLINE, Cochrane Library, Google Scholar) and bibliographic cross-referencing were performed to identify appropriate studies. Data extraction and synthesis was performed with the primary outcomes being the sensitivity and specificity of CE for detecting clinically significant abnormalities. Statistical analysis was performed using Open Meta-Analyst software. Narrative review of outcomes including those of clinical and radiological leaks was also undertaken.
resultsA total of 1,142 CE from 11 articles were included in the final meta-analysis. CE had high specificity (95.4; 95 % confidence interval = 92.0-97.4) and negative predictive value (98.4; 97.4-99.1) and moderate sensitivity (79.9; 63.9-89.9) and positive predictive value (64.6; 55.5-72.9) for the detection of clinically significant anastomotic problems. There was a high degree of correlation between CE and clinical examination findings (96.7 %). Occult radiological leaks were seen in 5.7 % of CE, and all but one (97 %) eventually underwent successful reversal. Only three quarters of patients with clinical leak underwent successful reversal.
conclusionCE is effective at excluding clinically significant anastomotic problems, especially after clinical anastomotic leaks. However, false positive results can be observed in asymptomatic patients, and it is unclear how much additional information CE provides over clinical assessment in the low uncomplicated anastomosis.
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