SynthesisTechniques in coloproctology2020
Impact of the number of stapler firings on anastomotic leakage in laparoscopic rectal surgery: a systematic review and meta-analysis.
Synthesis in Techniques in coloproctology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 3 of them syntheses that pooled it.
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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.
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Who cites it
41 citing papers in PubMed, 3 syntheses or guidelines pooled it, 69 citations in OpenAlex.
- The impact of the number of stapler firings on anastomotic leakage in minimally invasive rectal surgery: risk factor or technical marker of complexity? A systematic review, meta‑analysis, and metaregression.Techniques in coloproctology · 2026Pooled it
- Visceral obesity and anastomotic leakage rates in colorectal cancer: a systematic review and meta-analysis.Frontiers in oncology · 2023Pooled it
- A meta-analysis of the role of diverting ileostomy after rectal cancer surgery.International journal of colorectal disease · 2021Pooled it
- Perioperative safety evaluation of intersphincteric resection combined with rectal eversion and total extra-abdominal resection: a prospective randomized controlled trial.World journal of surgical oncology · 2025Trial
- Development and validation of an anastomotic risk score for use in a randomized clinical trial on defunctioning stoma use in low anterior resection for rectal cancer.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025Trial
- Robotic vs. Laparoscopic Stapling in Robotic Total Mesorectal Excision: A Prospective Cohort Study.Cureus · 2026Article
- Prevention, Recognition, and Management of Anastomotic Leakage and Pelvic Sepsis After Rectal Cancer Surgery: A Structured Narrative Review.Journal of clinical medicine · 2026Review
- Bow tie technique for single stapled colorectal anastomosis: observational cohort study.Surgical endoscopy · 2026Observational
- Development of a nomogram for predicting anastomotic leakage after rectal cancer surgery incorporating inflammatory indices.Frontiers in oncology · 2026Article
- Anastomotic Leak Following Colorectal Surgery.Clinics in colon and rectal surgery · 2026Review
- A novel technique for low-rectal cancer: Pushing the anus in laparoscopic radical resection.Medicine · 2025Observational
- Review
- Article
- Analysis of decision-making factors for defunctioning ileostomy after rectal cancer surgery and their impact on perioperative recovery: a retrospective study of 1082 patients.Surgical endoscopy · 2024Article
- The impact of powered circular staplers on anastomotic leak in left-sided colorectal cancer surgeries.Surgical endoscopy · 2024Article
- Simple pelvimetry predicts the pelvic manipulation time in robot-assisted low and ultra-low anterior resection for rectal cancer.Surgery today · 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
- 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
- Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery.Ewha medical journal · 2023Review
- Predicting multiple linear stapler firings in double stapling technique with an MRI-based deep-learning model.Scientific reports · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeveral univariate and multivariate studies have already identified the number of stapler firings for laparoscopic rectal transection for rectal cancer as an independent risk factor for anastomotic leakage. The aim of this study was to perform a systematic review and meta-analysis of the anastomotic leakage rate in laparoscopic rectal surgery according to the need of using one or two stapler firings for rectal transection.
methodsPubMed, Ovid, the Cochrane Library database and ClinicalTrials.gov were searched. All of the statistical analyses were performed using Revman software.
resultsFive studies were included (1267 patients). The overall anastomotic leakage rate was 5.5% [0.7-8.4%]. Anastomotic leak occurred in 3.5% (17/491) of the cases where 1 stapler firing was used versus 6.7% (50/786) of the cases in which 2 firings were needed (50/786). Two stapler firings were significantly associated with an increased risk of anastomotic leakage (OR 2.44, 95% CI 1.34-4.42, p = 0.003, I
conclusionsOur systematic review and meta-analysis suggest that two firings imply a higher rate of anastomotic leak than a single firing after laparoscopic rectal surgery with a double stapling technique. Coloproctologists should strive to reduce the number of linear stapler firings and try to transect the rectum with a single firing.
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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.