ArticleEuropean radiology2015
Anastomotic leakage after colorectal surgery: diagnostic accuracy of CT.
Article in European radiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
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Who cites it
29 citing papers in PubMed, 54 citations in OpenAlex.
- Early postoperative endoscopic evaluation of rectal anastomoses: a prospective cross-sectional study.Surgical endoscopy · 2022Trial
- Mesenteric Diatrizoate Pooling Mimicking an Anastomotic Leak in Multi-Organ Dysfunction.Clinical case reports · 2026Article
- Strategies to Reduce the Risk of Rectal Stump Leakage After Hartmann's Procedure: A Structured Narrative Review.Cureus · 2026Review
- Preoperative insulin resistance and stress response increase the risk of anastomotic leakage after colorectal cancer resection.Scientific reports · 2025Article
- Diagnostic value of CT scan findings for anastomotic leakage after low anterior resection without ileostomy in rectal cancer.Scientific reports · 2025Article
- Diagnostic Value of Postsurgical Endoscopy.Visceral medicine · 2025Review
- Added value of positive intraluminal contrast CT over fluoroscopic examination for detecting gastrointestinal leakage after gastrointestinal surgery.Scientific reports · 2024Article
- CT scan for early diagnosis of anastomotic leak after colorectal surgery: is rectal contrast useful?Techniques in coloproctology · 2023Article
- Significance of Postprocedural Contrast Medium Injection after CT-Guided Abscess Drainage.Tomography (Ann Arbor, Mich.) · 2023Article
- Effectiveness of computed tomography scoring for the early diagnosis of anastomotic leakage after esophagectomy.Langenbeck's archives of surgery · 2023Article
- Interobserver Variability in the Assessment of Fluorescence Angiography in the Colon.Surgical innovation · 2023Article
- MRI diagnose post-operative anastomotic leak in patients with rectal cancer: preliminary experience.BMC surgery · 2022Article
- Treatment Modalities for Anastomotic Leakage in Rectal Cancer Surgery.Clinics in colon and rectal surgery · 2021Review
- The importance of rectal contrast in CT assessment to detect anastomotic leakage after colorectal surgery.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2021Article
- The Association of Coloproctology of Great Britain and Ireland consensus guidelines in emergency colorectal surgery.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2021Article
- Computed tomography in suspected anastomotic leakage after colorectal surgery: evaluating mortality rates after false-negative imaging.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2020Article
- Consensus on the definition of colorectal anastomotic leakage: A modified Delphi study.World journal of gastroenterology · 2020Article
- Radiological findings in anastomotic leakage after anterior resection may predict a permanent stoma.Acta radiologica open · 2020Article
- Elucidating vaginal fistulas on CT and MRI.Insights into imaging · 2019Review
- Management of anastomotic leakage after rectal surgery: a review article.Journal of gastrointestinal oncology · 2019Review
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo evaluate the diagnostic accuracy of CT in postoperative colorectal anastomotic leakage (AL).
methodsTwo independent blinded radiologists reviewed 153 CTs performed for suspected AL within 60 days after surgery in 131 consecutive patients, with (n = 58) or without (n = 95) retrograde contrast enema (RCE). Results were compared to original interpretations. The reference standard was reoperation or consensus (a radiologist and a surgeon) regarding clinical, laboratory, radiological, and follow-up data after medical treatment.
resultsAL was confirmed in 34/131 patients. For the two reviewers and original interpretation, sensitivity of CT was 82 %, 87 %, and 71 %, respectively; specificity was 84 %, 84 %, and 92 %. RCE significantly increased the positive predictive value (from 40 % to 88 %, P = 0.0009; 41 % to 92 %, P = 0.0016; and 40 % to 100 %, P = 0.0006). Contrast extravasation was the most sensitive (reviewers, 83 % and 83 %) and specific (97 % and 97 %) sign and was significantly associated with AL by univariate analysis (P < 0.0001 and P < 0.0001). By multivariate analysis with recursive partitioning, CT with RCE was accurate to confirm or rule out AL with contrast extravasation.
conclusionsCT with RCE is accurate for diagnosing postoperative colorectal AL. Contrast extravasation is the most reliable sign. RCE should be performed during CT for suspected AL. KEY POINTS: • CT accurately diagnosed clinically suspected colorectal AL and showed good interobserver agreement • Contrast extravasation was the most sensitive and specific CT sign • Retrograde contrast enema during CT improved positive predictive value • Retrograde contrast enema decreased false-negative or indeterminate original CT interpretations.
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