ArticleColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland2021
The importance of rectal contrast in CT assessment to detect anastomotic leakage after colorectal surgery.
Article in Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed, 18 citations in OpenAlex.
- Prevention, Recognition, and Management of Anastomotic Leakage and Pelvic Sepsis After Rectal Cancer Surgery: A Structured Narrative Review.Journal of clinical medicine · 2026Review
- Management of Low Colorectal/Coloanal Anastomotic Leak: Results of a French National Intergroups Practice Survey (FRENCH-GRECCAR-SFCD).World journal of surgery · 2025Article
- Diagnostic value of CT scan findings for anastomotic leakage after low anterior resection without ileostomy in rectal cancer.Scientific reports · 2025Article
- Predictive Factors for Anastomotic Leakage Following Colorectal Cancer Surgery: Where Are We and Where Are We Going?Current oncology (Toronto, Ont.) · 2023Review
- MRI diagnose post-operative anastomotic leak in patients with rectal cancer: preliminary experience.BMC surgery · 2022Article
- The importance of rectal contrast in CT assessment to detect anastomotic leakage after colorectal surgery.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2021Article
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6 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
aimComputed tomography (CT) is currently the diagnostic tool most often used to detect anastomotic leakage (AL) after colorectal surgery. The aim of this study was to investigate the value of rectal contrast.
methodAll patients who underwent colorectal surgery with a primary anastomosis between 2009 and 2018 were identified from a prospectively maintained database. Patients who underwent postoperative CT scanning in suspicion of AL were included. The clinical and radiological outcomes of patients with and without rectal contrast were compared.
resultsA total of 1183 patient records were reviewed; 225 patients underwent CT-abdomen in suspicion of AL. Of these patients, 175 (77.8%) received rectal contrast. Sensitivity and specificity in this group were 78% and 94%, respectively. The positive predictive value (PPV) was 0.78 and the negative predictive value (NPV) was 0.94. In the group without rectal contrast (n = 50), sensitivity was 47%, specificity 88%, PPV 0.66 and NPV 0.76. In patients who received rectal contrast, contrast reached the anastomosis in 81.7% compared with 26.0% in patients who were given only oral contrast (p < 0.001). The sensitivity increased to 93% in the group of patients with contrast at the anastomosis, the specificity to 97%, the PPV to 0.88 and the NPV to 0.98. No adverse events were observed after the use of rectal contrast.
conclusionThe use of rectal contrast led to a significant increase in the predictive value of CT scanning for AL, especially when it reached the anastomosis. This suggests that rectal contrast is a safe and useful adjunct to CT-abdomen in the detection of AL.
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