Evidence map›Paper›PMID 37173554›Full record

ArticleInternational journal of colorectal disease2023

Transanal formation of anastomosis using C-REX device is feasible and effective in high anterior resection.

Dadi Vilhjalmsson, Mattias Lepsenyi, Ingvar Syk, Anders Grönberg, Henrik Thorlacius

Open access · hybridAbstract read
In one paragraph

Article in International journal of colorectal disease, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.5field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Comparison of the C-REX LapAid and Circular Stapled Colorectal Anastomoses in an Experimental Model.European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Dadi VilhjalmssonDepartment of Clinical Sciences, Section of Surgery, Malmö, Lund University, Malmö, 205 02, Sweden.
Mattias LepsenyiDepartment of Clinical Sciences, Section of Surgery, Malmö, Lund University, Malmö, 205 02, Sweden.
Ingvar SykDepartment of Clinical Sciences, Section of Surgery, Malmö, Lund University, Malmö, 205 02, Sweden.
Anders GrönbergSection of Development, CarpoNovum, Halmstad, 302 41, Sweden.
Henrik ThorlaciusDepartment of Clinical Sciences, Section of Surgery, Malmö, Lund University, Malmö, 205 02, Sweden. henrik.thorlacius@med.lu.se.
Malmö University · SELund University · SE

Funding

Cancerfonden 190428 PjSwedish Research Council 2021-02405
6 · The paper itself

Abstract

purposeC-REX is a novel instrument for creating stapleless colorectal anastomosis by compression. The aim of this study was to evaluate the feasibility and effectiveness of C-REX in open and laparoscopic high anterior resections.

methodsA prospective clinical safety study on 21 patients reconstructed with C-REX colorectal anastomosis following high anterior resection of the sigmoid colon using two different devices for intraabdominal (n = 6) or transanal (n = 15) placement of the anastomotic rings. Any signs of complications were prospectively monitored by a predefined protocol. Anastomotic contact pressure (ACP) was measured via a catheter-based system, and time for evacuation of the anastomotic rings by the natural route was noted. Blood samples were collected daily, and flexible endoscopy was performed postoperatively to examine macroscopic appearance of the anastomoses.

resultsOne of six patients operated with the intraabdominal anastomosis technique with an ACP of 50 mBar had to be reoperated because of anastomotic leakage. None of the 15 patients operated with the transanal technique (5 open and 10 laparoscopic procedures) had anastomotic complications, and their ACP ranged between 145 and 300 mBar. C-REX rings were uneventfully expelled by the natural route in all patients after a median of 10 days. Flexible endoscopy showed well-healed anastomoses without stenosis in 17 patients and a moderate subclinical stricture in one patient.

conclusionThese results indicate that the novel transanal C-REX device is a feasible and effective method for colorectal anastomosis following high anterior resections, irrespective of open or laparoscopic approach. Moreover, C-REX allows measurement of intraoperative ACP and thereby a quantitative evaluation of the anastomotic integrity.

Indexed as

Anastomotic LeakColorectal NeoplasmsAnastomosis, SurgicalHumansProspective StudiesRectumAnastomosisCARPColorectalCompressionC-REXHealing

Identifiers

PMID37173554
PMCPMC10182144
OpenAlexW4376630823

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.