Trial reportSurgical endoscopy2022
Early postoperative endoscopic evaluation of rectal anastomoses: a prospective cross-sectional study.
Trial report in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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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
7 citing papers in PubMed, 13 citations in OpenAlex.
- Diagnostic accuracy of C-reactive protein in detecting anastomotic leakage after minimally invasive rectal cancer surgery.Surgical endoscopy · 2026Article
- Open versus laparoscopic right colectomy: does the initial approach impact on management and outcomein anastomotic leakage? A multicenter cohort study.Updates in surgery · 2025Observational
- Diagnostic Value of Postsurgical Endoscopy.Visceral medicine · 2025Review
- Bedside endoscopic inspection of colorectal anastomoses in the early postoperative period: a 2-center prospective feasibility study.Annals of coloproctology · 2025Article
- Perioperative assessment of colorectal anastomoses with flexible endoscopy.Updates in surgery · 2025Article
- Non-Thermal Atmospheric Pressure Plasma as an Adjunct to Intestinal Anastomosis: A Pilot Study on Preventing Anastomotic Leaks.Life (Basel, Switzerland) · 2024Article
- Challenges in the interdisciplinary treatment of leakages after left-sided colorectal surgery: endoscopic negative pressure therapy, open-pore film drainage therapy and beyond.International journal of colorectal disease · 2023Article
Corrections and comments
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Authors and funding
11 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundReported incidence of anastomotic leakage (AL) of rectal anastomoses is up to 29% with an overall mortality up to 12%. Nevertheless, there is no uniform evidence-based diagnostic procedure for early detection of AL. The objective of this prospective clinical trial was to demonstrate the diagnostic value of early postoperative flexible endoscopy for rectal anastomosis evaluation.
methodsFlexible endoscopy between 5 and 8th postoperative day was performed consecutively in 90 asymptomatic patients. Sample size calculation was made using the two-stage Simon design. Diagnostic value was measured by management change after endoscopic evaluation. Anastomoses were categorized according to a new classification. Study is registered in German Clinical Trials Register (DRKS00019217).
resultsOf the 90 anastomoses, 59 (65.6%) were unsuspicious. 20 (22.2%) were suspicious with partial fibrin plaques (n = 15), intramural hematoma and/or local blood coagulum (n = 4) and ischemic area in one. 17 of these anastomoses were treated conservatively under monitoring. In three a further endoscopic re-evaluation was performed and as consequence one patient underwent endoscopic vacuum therapy. 11 (12.2%) AL were detected. Here, two could be treated conservatively under monitoring, four with endoscopic vacuum therapy and five needed revision surgery. No intervention-related adverse events occurred. A change in postoperative management was made in 31 (34.4%) patients what caused a significant improvement of diagnosis of AL (p < 0.001).
conclusionsEarly postoperative endoscopic evaluation of rectal anastomoses is a safe procedure thus allows early detection of AL. Early treatment for suspicious anastomoses or AL could be adapted to avoid severe morbidity and mortality.
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