ArticleSurgical endoscopy2019
Intraoperative air leak test reduces the rate of postoperative anastomotic leak: analysis of 777 laparoscopic left-sided colon resections.
Article in Surgical endoscopy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 3 of them syntheses that pooled it.
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Who cites it
17 citing papers in PubMed, 3 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Ghost Ileostomy Versus Loop Ileostomy Following Oncologic Resection for Rectal Cancer: A Systematic Review and Meta-Analysis.Surgical innovation · 2023Pooled it
- Intraoperative testing of colorectal anastomosis and the incidence of anastomotic leak: A meta-analysis.Medicine · 2020Pooled it
- A standardized use of intraoperative anastomotic testing in colorectal surgery in the new millennium: is technology taking over? A systematic review and network meta-analysis.Techniques in coloproctology · 2019Pooled it
- Anastomotic reinforcement in rectal surgery: a position statement from an expert panel of colorectal surgeons.Updates in surgery · 2026Article
- Large Bowel Obstruction: Etiologies, Diagnosis, and Management.Clinics in colon and rectal surgery · 2024Review
- 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
- Intraoperative fluorescence angiography as an independent factor of anastomotic leakage and a nomogram for predicting leak for colorectal anastomoses.Annals of coloproctology · 2022Article
- Intraoperative Colonoscopy in Laparoscopic Rectal Cancer Surgery Reduces Anastomotic Leakage.Journal of the anus, rectum and colon · 2022Article
- Anastomotic Troubleshooting.Clinics in colon and rectal surgery · 2021Review
- Experimental Study of Mechanical Integrity Testing in Stapled Large Bowel: Methylene Blue Leak Test Is Not Inferior to Air Leak Test.Visceral medicine · 2021Article
- Clinical and economic burden of colorectal and bariatric anastomotic leaks.Surgical endoscopy · 2020Article
- Italian multi-society modified Delphi consensus on the definition and management of anastomotic leakage in colorectal surgery.Updates in surgery · 2020Article
- Long-term oncologic outcomes following anastomotic leak after anterior resection for rectal cancer: does the leak severity matter?Surgical endoscopy · 2020Article
- Reducing anastomotic leak in colorectal surgery: The old dogmas and the new challenges.World journal of gastroenterology · 2019Review
- Modified Colon Leakage Score to Predict Anastomotic Leakage in Patients Who Underwent Left-Sided Colorectal Surgery.Journal of clinical medicine · 2019Article
- Risk Factors and Preventive Measures for Anastomotic Leak in Colorectal Cancer.Technology in cancer research & treatmentReview
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe evidence supporting the use of the air leak test (ALT) after laparoscopic left-sided colon resection (LLCR) to test the colorectal anastomosis (CA) integrity aiming at reducing the rate of postoperative CA leakage (CAL) is not conclusive. The aim of this study was to challenge the use of ALT after elective LLCR.
methodsIt is a retrospective analysis of a prospectively collected database including all patients undergoing elective LLCR with primary CA and no proximal bowel diversion between January 1996 and June 2017. The decision to perform the ALT was based on the individual surgeon routine practice. A multivariate analysis was performed to identify independent risk factors for CAL.
resultsA total of 777 LLCR without proximal diversion were included in the analysis: the CA was tested in 398 patients (ALT group), while intraoperative ALT was not performed in 379 patients (No-ALT group). The two groups were similar in demographic characteristics, indication, and type of procedure. Intraoperative ALT was positive in 20 (5%) patients: a stoma was created in 14 (70%) patients, while 6 (30%) patients had a suture repair alone. Overall, postoperative CAL occurred in 32 patients (4.1%): the postoperative CAL rate was lower in ALT patients (2.5% vs. 5.8%, p = 0.025). A reoperation was needed in 87.5% of cases. No CAL occurred in the 20 patients with intraoperative positive ALT. Multivariate analysis showed that ASA score 3-4 (OR 5.39, 95% CI 2.53-11.51, p < 0.001) and male sex (OR 3.96, 95% CI 1.66-9.43, p = 0.002) were independent risk factors for postoperative CAL, while intraoperative ALT independently reduced the postoperative CAL rate (OR 0.40, 95% CI 0.18-0.88, p = 0.022).
conclusionIntraoperative ALT allows to detect AL defects after LLCR that can be effectively managed intraoperatively, leading to a significant lower risk of postoperative CAL.
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