ArticleInternational journal of colorectal disease2019
Laparoscopic surgery may decrease the risk of clinical anastomotic leakage and a nomogram to predict anastomotic leakage after anterior resection for rectal cancer.
Article in International journal of colorectal disease, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 2 of them syntheses that pooled it.
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36 citing papers in PubMed, 2 syntheses or guidelines pooled it, 54 citations in OpenAlex.
- 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
- Systematic review of preoperative and intraoperative colorectal Anastomotic Leak Prediction Scores (ALPS).BMJ open · 2023Pooled it
- Trial
- Machine learning model-guided selective use of temporary diverting ileostomy in rectal cancer surgery: a randomized controlled trial.Nature communications · 2026Trial
- Comparison of the operative outcomes and learning curves between laparoscopic and "Micro Hand S" robot-assisted total mesorectal excision for rectal cancer: a retrospective study.BMC gastroenterology · 2021Trial
- Development of a nomogram for predicting anastomotic leakage after rectal cancer surgery incorporating inflammatory indices.Frontiers in oncology · 2026Article
- Prediction of anastomotic leakage after esophagectomy for esophageal cancer: a nomogram study integrating systemic inflammation indices and clinical factors.Frontiers in oncology · 2026Article
- Ghost Ileostomy Versus Protective Ileostomy in Rectal Cancer Followed by Low Anterior Resection: A Randomized Feasibility Trial.Health science reports · 2025Article
- Impact of Surgical Approach, Patient Risk Factors, and Diverting Ileostomy on Anastomotic Leakage and Outcomes After Rectal Cancer Resection: A 5-Year Single-Center Study.Medicina (Kaunas, Lithuania) · 2025Article
- Building a risk prediction model for anastomotic leakage postoperative low rectal cancer based on Lasso-Logistic regression.BMC gastroenterology · 2025Article
- Clinical prediction model for anastomotic leakage in rectal cancer surgery: a single-center large-sample cohort study.Surgical endoscopy · 2025Article
- Incidence of intestinal obstruction after sigmoid extraperitoneal colostomy combined with pelvic peritoneal closure in abdominoperineal resection for low rectal cancer.Techniques in coloproctology · 2025Article
- Article
- Serum nutritional predictive biomarkers and risk assessment for anastomotic leakage after laparoscopic surgery in rectal cancer patients.World journal of gastrointestinal surgery · 2024Article
- The impact of transanal drainage tube on the incidence of anastomotic leakage and small bowel obstruction in radical surgery (Dixon) for rectal cancer: a retrospective cohort study.Journal of gastrointestinal oncology · 2024Article
- Machine learning-based preoperative analytics for the prediction of anastomotic leakage in colorectal surgery: a swiss pilot study.Surgical endoscopy · 2024Article
- Risk factor analysis and predictive model construction for postoperative bleeding in early esophageal cancer.American journal of translational research · 2024Article
- Establishment and application of three predictive models of anastomotic leakage after rectal cancer sphincter-preserving surgery.World journal of gastrointestinal surgery · 2023Article
- Risk assessment of rectal anastomotic leakage (RAREAL) after DIXON in non-emergency patients with rectal cancer.BMC gastroenterology · 2023Article
- Predictive factors associated with anastomotic leakage after resection of rectal cancer: a multicenter study with the Hiroshima Surgical study group of Clinical Oncology.Langenbeck's archives of surgery · 2023Article
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAnastomotic leakage is still one of the most dreaded complications after anterior resection for rectal cancer. This study aimed to identify risk factors for anastomotic leakage and to create a nomogram for precise prediction of anastomotic leakage after anterior resection for rectal cancer.
methodsTwo thousand six hundred eighteen consecutive patients who underwent anterior resection for rectal cancer with primary anastomosis, with or without diverting stoma, were retrospectively analyzed as a training dataset. Univariate and multivariable Cox regression analyses were used to determine independent risk factors associated with anastomotic leakage. A nomogram was constructed to predict anastomotic leakage. Data containing 611 patients were prospectively collected as a test dataset. The performance of the nomogram was evaluated by using a bootstrapped-concordance index and calibration plots.
resultsThe rate of clinical anastomotic leakage was 9.3% in the training dataset. Multivariate analysis identifies the following variables as independent risk factors for anastomotic leakage: gender (male) (odds ratio (OR) = 2.286), distance of tumor to anal verge (OR = 0.791), tumor size (OR = 1.175), operating time (OR = 1.009), diabetes mellitus (OR = 1.704), laparoscopic surgery (OR = 0.445), anastomotic bleeding (OR = 13.46), and diverting stoma (OR = 0.386). We created a nomogram with high discriminative ability (concordance index, 0.722). The area under the curve value, which evaluated the predictive performance of external validation, was 0.723.
conclusionsA protective diverting stoma and laparoscopic surgery significantly decrease the risk of anastomotic leakage. Our nomogram was a useful tool for precise prediction of anastomotic leakage after anterior resection for rectal cancer.
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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.