Evidence map›Paper›PMID 29751360›Full record

ArticleColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland2018

IntAct: intra-operative fluorescence angiography to prevent anastomotic leak in rectal cancer surgery: a randomized controlled trial.

G Armstrong, J Croft, N Corrigan, J M Brown, V Goh, P Quirke, C Hulme, D Tolan, A Kirby, R Cahill and 4 more

Open access · hybridAbstract readClinical Trial ProtocolMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
64citing papers in PubMed, 7 pooled it
4.8field-weighted citation impact, top 3% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

64 citing papers in PubMed, 7 syntheses or guidelines pooled it, 110 citations in OpenAlex.

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  5. 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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  12. The perioperative microbiome of patients undergoing rectal cancer surgery: A pilot study.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026
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4 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

14 authors at 8 institutions in 2 countries.

G ArmstrongSt James' University Hospital, Leeds, UK.
J CroftClinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK.
N CorriganClinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK.
J M BrownClinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK.
V GohSchool of Biomedical Engineering and Imaging Sciences, King's College London and Honorary Consultant Radiologist, Guy's and St Thomas' Hospitals NHS Foundation Trust, London, UK.
P QuirkeUniversity of Leeds, Leeds, UK.
C HulmeAcademic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
D TolanLeeds Teaching Hospital Trust, Leeds, UK.
A KirbyUniversity of Leeds, Leeds, UK.
R CahillUniversity College Dublin, Dublin, Ireland.
P R O'ConnellSt Vincent's University Hospital, Dublin, Ireland.
D MiskovicSt Mark's Hospital, London, UK.
M ColemanDerriford Hospital, Plymouth NHS Trust, Plymouth, UK.
D JayneLeeds Institute of Biological and Clinical Sciences, St James's University Hospital, Leeds, UK.
University of Leeds · GBSt James's University Hospital · GBDerriford Hospital · GBKing's College London · GBLeeds Teaching Hospitals NHS Trust · GBSt Mark's Hospital · GBSt. Vincent's University Hospital · IEUniversity College Dublin · IE

Funding

Cancer Research UK 16463Department of Health 09/22/49
6 · The paper itself

Abstract

aimAnastomotic leak (AL) is a major complication of rectal cancer surgery. Despite advances in surgical practice, the rates of AL have remained static, at around 10-15%. The aetiology of AL is multifactorial, but one of the most crucial risk factors, which is mostly under the control of the surgeon, is blood supply to the anastomosis. The MRC/NIHR IntAct study will determine whether assessment of anastomotic perfusion using a fluorescent dye (indocyanine green) and near-infrared laparoscopy can minimize the rate of AL leak compared with conventional white-light laparoscopy. Two mechanistic sub-studies will explore the role of the rectal microbiome in AL and the predictive value of CT angiography/perfusion studies.

methodIntAct is a prospective, unblinded, parallel-group, multicentre, European, randomized controlled trial comparing surgery with intra-operative fluorescence angiography (IFA) against standard care (surgery with no IFA). The primary end-point is rate of clinical AL at 90 days following surgery. Secondary end-points include all AL (clinical and radiological), change in planned anastomosis, complications and re-interventions, use of stoma, cost-effectiveness of the intervention and quality of life. Patients should have a diagnosis of adenocarcinoma of the rectum suitable for potentially curative surgery by anterior resection. Over 3 years, 880 patients from 25 European centres will be recruited and followed up for 90 days. DISCUSSION: IntAct will rigorously evaluate the use of IFA in rectal cancer surgery and explore the role of the microbiome in AL and the predictive value of preoperative CT angiography/perfusion scanning.

Indexed as

Fluorescein AngiographyAdenocarcinomaAnastomosis, SurgicalAnastomotic LeakComputed Tomography AngiographyGastrointestinal MicrobiomeHumansIntraoperative PeriodPredictive Value of TestsProspective StudiesRandomized Controlled Trials as TopicRectal NeoplasmsRectumanastomotic leakIntra-operative fluorescence angiographyrandomized controlled trialrectal cancerresection

Identifiers

PMID29751360
PMCPMC6099475
OpenAlexW2802811449

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.