ArticleSurgical endoscopy2018
Vacuum-assisted early transanal closure of leaking low colorectal anastomoses: the CLEAN study.
Article in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 3 of them syntheses that pooled it.
What it found
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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
48 citing papers in PubMed, 3 syntheses or guidelines pooled it, 96 citations in OpenAlex.
- Endoscopic Treatment Options for Gastrointestinal Leaks.Visceral medicine · 2022Pooled it
- Endoscopic vacuum therapy and early surgical closure after pelvic anastomotic leak: meta-analysis of bowel continuity rates.The British journal of surgery · 2022Pooled it
- Endoscopic vacuum therapy for the treatment of colorectal leaks - a systematic review and meta-analysis.International journal of colorectal disease · 2022Pooled it
- Prevention, Recognition, and Management of Anastomotic Leakage and Pelvic Sepsis After Rectal Cancer Surgery: A Structured Narrative Review.Journal of clinical medicine · 2026Review
- Endoscopic management for gastrointestinal leaks, perforations, and fistulae: Technical tips and outcomes.World journal of gastrointestinal endoscopy · 2025Review
- Metabolic dysfunction‑associated steatotic liver disease: Pathogenesis, model and treatment (Review).International journal of molecular medicine · 2025Review
- Hospital costs of different treatment strategies for anastomotic leakage after total mesorectal excision: a multicentre cost analysis.Techniques in coloproctology · 2025Article
- Management of Low Colorectal/Coloanal Anastomotic Leak: Results of a French National Intergroups Practice Survey (FRENCH-GRECCAR-SFCD).World journal of surgery · 2025Article
- Endoscopic Management of Anastomotic Insufficiencies in the Lower GI Tract.Visceral medicine · 2025Review
- Summary of the current guidelines for managing iatrogenic colorectal perforations and the evolving role of endoluminal vacuum therapy.World journal of clinical cases · 2025Article
- Transanal repair of anastomotic leakage after oncologic low anterior resection: a prospective cohort.Techniques in coloproctology · 2025Article
- Treatment of anastomotic leak in colorectal surgery by endoluminal vacuum therapy with the VACStent avoiding a stoma - a pilot study.Langenbeck's archives of surgery · 2024Article
- Influence of Neoadjuvant Therapy on Success of Endoscopic Vacuum Therapy in Anastomotic Leakage after Rectal Resection Because of Rectal Cancer.Journal of clinical medicine · 2024Article
- An Institutional Shift from Routine to Selective Diversion of Low Anastomosis in Robotic TME Surgery for Rectal Cancer Patients Using the KHANS Technique: A Single-Centre Cohort Study.Journal of personalized medicine · 2024Article
- Management of acute and chronic pelvic sepsis after total mesorectal excision for rectal cancer-a 10-year experience of a national referral centre.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2024Observational
- Successful treatment of anastomotic leakage with an intestinal obstruction catheter and stent by colonoscopy: a case report and brief literature review.Frontiers in oncology · 2024Article
- Stoma-free survival after anastomotic leak following rectal cancer resection: worldwide cohort of 2470 patients.The British journal of surgery · 2023Article
- Transanal minimally invasive surgery for rectal anastomotic complications after colorectal surgery.Techniques in coloproctology · 2023Article
- Comparison of proactive and conventional treatment of anastomotic leakage in rectal cancer surgery: a multicentre retrospective cohort series.Techniques in coloproctology · 2023Article
- Assessment of the efficacy of Handmade Vacuum-Assisted Sponge Drain for Treatment of Anastomotic leakage after Low Anterior Rectal Resection.Updates in surgery · 2023Article
Corrections and comments
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Authors and funding
10 authors at 7 institutions in 1 country.
Funding
Abstract
introductionNon-healing of anastomotic leakage can be observed in up to 50% after total mesorectal excision for rectal cancer. This study investigates the efficacy of early transanal closure of anastomotic leakage after pre-treatment with the Endosponge
methodsIn this prospective, multicentre, feasibility study, transanal suturing of the anastomotic defect was performed after vacuum-assisted cleaning of the presacral cavity. Primary outcome was the proportion of patients with a healed anastomosis at 6 months after transanal closure. Secondary, healing at last follow-up, continuity, direct medical costs, functionality and quality of life were analysed.
resultsBetween July 2013 and July 2015, 30 rectal cancer patients with a leaking low colorectal anastomosis were included, of whom 22 underwent neoadjuvant radiotherapy. Median follow-up was 14 (7-29) months. At 6 months, the anastomosis had healed in 16 (53%) patients. At last follow-up, anastomotic integrity was found in 21 (70%) and continuity was restored in 20 (67%) patients. Non-healing at 12 months was observed in 10/29 (34%) patients overall, and in 3/14 (21%) when therapy started within three weeks following the index operation. Major LARS was reported in 12/15 (80%) patients. The direct medical costs were €8933 (95% CI 7268-10,707) per patient.
conclusionVacuum-assisted early transanal closure of a leaking anastomosis after total mesorectal excision with 73% preoperative radiotherapy showed that acceptable anastomotic healing rates and stoma reversal rates can be achieved. Early diagnosis and start of treatment seems crucial.
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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.