SynthesisInternational journal of colorectal disease2016
Is the intraoperative air leak test effective in the prevention of colorectal anastomotic leakage? A systematic review and meta-analysis.
Synthesis in International journal of colorectal disease, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 3 of them syntheses that pooled it.
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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.
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Who cites it
38 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Risk and protective factors for postoperative anastomotic leakage in esophageal and gastrointestinal surgery: an umbrella review of meta-analyses and systematic reviews.International journal of surgery (London, England) · 2026Pooled it
- Clinical Practice Guideline: Recommendations for the Perioperative Management of Pancreatic and Colorectal Cancer Patients.Deutsches Arzteblatt international · 2024Guideline
- Impact of change in the surgical plan based on indocyanine green fluorescence angiography on the rates of colorectal anastomotic leak: a systematic review and meta-analysis.Surgical endoscopy · 2022Pooled it
- Early postoperative endoscopic evaluation of rectal anastomoses: a prospective cross-sectional study.Surgical endoscopy · 2022Trial
- Clinical Risk Management and Postoperative Outcomes After Colorectal Resection: A Retrospective Observational Study.Journal of personalized medicine · 2026Article
- Safety and Feasibility Colorectal Anastomosis Protocol Implementation: Results from the CASPI Single-Arm Pilot Study.Cancers · 2026Article
- Ex Vivo and Simulation Comparison of Leakage in End-to-End Versus End-to-Side Anastomosed Porcine Large Intestine.Bioengineering (Basel, Switzerland) · 2025Article
- Article
- Article
- The Value of C-Reactive Protein and Peritoneal Cytokines as Early Predictors of Anastomotic Leak after Colorectal Surgery.Diagnostics (Basel, Switzerland) · 2024Article
- Quadruple Assessment of Colorectal Anastomosis after Laparoscopic Rectal Resection: A Retrospective Analysis of a Propensity-Matched Cohort.Journal of clinical medicine · 2024Article
- Poly-ϵ-caprolactone scaffold as staple-line reinforcement of rectal anastomosis: an experimental piglet study.BMC gastroenterology · 2024Article
- Validation of an endoscopic anastomotic grading score as an intraoperative method for assessing stapled rectal anastomoses.Techniques in coloproctology · 2023Article
- Risk assessment of rectal anastomotic leakage (RAREAL) after DIXON in non-emergency patients with rectal cancer.BMC gastroenterology · 2023Article
- Efficacy of air leak test in detection of anastomotic leaks after rectal excision: a retrospective case-controlled study.Annals of surgical treatment and research · 2023Article
- Optimal anastomotic technique in rectal surgery to prevent anastomotic leakage.Annals of coloproctology · 2023Review
- International survey among surgeons on the perioperative management of rectal cancer.Surgical endoscopy · 2023Article
- The Colorectal Anastomosis: A Timeless Challenge.Clinics in colon and rectal surgery · 2023Review
- Techniques for Diagnosing Anastomotic Leaks Intraoperatively in Colorectal Surgeries: A Review.Cureus · 2023Review
- A multidimensional learning curve analysis of totally laparoscopic ileostomy reversal using a single surgeon' s experience.Frontiers in surgery · 2023Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe intra-operative air leak test (ALT) is a common intraoperative test used to identify mechanically insufficient anastomosis. This meta-analysis aims to determine whether ALT aids to the reduction of postoperative colorectal anastomotic leakage (CAL).
methodsA literature search was performed to select studies in acknowledged databases. Full text articles targeting ALT during colorectal surgery were included. Quality assessment, risk of bias, and the level-of-evidence of the inclusions were evaluated. ALT methodology, ALT(+) (i.e., leak observed during the test) rate, and postoperative CAL rate of the included studies were subsequently analyzed.
resultsTwenty studies were included for analysis, in which we found substantial risks of bias. A lower CAL rate was observed in patients who underwent ALT than those did not; however, the difference was not significant (p = 0.15). The intraoperative ALT(+) rate greatly varied among the included studies from 1.5 to 24.7 %. ALT(+) patients possessed a significantly higher CAL rate than the ALT(-) patients (11.4 vs. 4.2 %, p < 0.001).
conclusionsBased on the available evidence, performing an ALT with the reported methodology has not significantly reduced the clinical CAL rate but remains necessary due to a higher risk of CAL in ALT(+) cases. Unfortunately, additional repairs under current methods may not effectively decrease this risk. Results of this review urge a standardization of ALT methodology and effective methods to repair ALT(+) anastomoses.
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