Evidence map›Paper›PMID 37184769›Full record

ArticleTechniques in coloproctology2023

Validation of an endoscopic anastomotic grading score as an intraoperative method for assessing stapled rectal anastomoses.

C Farzaneh, A Uppal, M D Jafari, W Q Duong, J C Carmichael, S D Mills, M J Stamos, A Pigazzi

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Article in Techniques in coloproctology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.2field-weighted citation impact, top 18% 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

3 citing papers in PubMed, 5 citations in OpenAlex.

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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

8 authors at 3 institutions in 1 country.

C FarzanehDivision of Colon and Rectal Surgery, Department of Surgery, University of California, Irvine, Orange, CA, USA.ORCID 0000-0001-8269-076X
A UppalDivision of Surgery, Department of Colon and Rectal Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
M D JafariDepartment of Surgery, New York Presbyterian Hospital Weill Cornell College of Medicine, 525 E 68th Street, NY, New York, USA.
W Q DuongDivision of Colon and Rectal Surgery, Department of Surgery, University of California, Irvine, Orange, CA, USA.
J C CarmichaelDivision of Colon and Rectal Surgery, Department of Surgery, University of California, Irvine, Orange, CA, USA.
S D MillsDivision of Colon and Rectal Surgery, Department of Surgery, University of California, Irvine, Orange, CA, USA.
M J StamosDivision of Colon and Rectal Surgery, Department of Surgery, University of California, Irvine, Orange, CA, USA.
A PigazziDepartment of Surgery, New York Presbyterian Hospital Weill Cornell College of Medicine, 525 E 68th Street, NY, New York, USA. alp9001@med.cornell.edu.
University of California, Irvine · USNewYork–Presbyterian Hospital · USThe University of Texas MD Anderson Cancer Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAnastomotic leak is a dreaded complication of colorectal surgery. An endoscopic grading score of the perianastomotic mucosa has been previously developed at our institution (UCI) to assess colorectal anastomotic integrity. The objective of this study is to validate the UCI anastomotic score and determine its impact in anastomotic failure.

methodsAs a follow-up study of the UCI grading score implementation during 2011 to 2014, patients undergoing stapled colorectal anastomoses after sigmoidectomy or proctectomy at a single institution from 2015 to 2018 were retrospectively reviewed. Patients were grouped into three tiers based on endoscopic appearance (grade 1, circumferentially normal mucosa; grade 2, ischemia/congestion < 30% of circumference; grade 3, ischemia/congestion > 30% of circumference).

resultsOn the basis of endoscopic mucosal evaluation, grade 1 anastomosis was observed in 299 patients (94%), grade 2 anastomosis in 14 patients (4.4%), and grade 3 anastomosis in 5 patients (1.6%). All grade 3 classifications were immediately and successfully revised intraoperatively with reclassification as a grade 1 anastomosis. The anastomotic leak rate of the follow-up study period from 2015 to 2018 was 6.4% which was lower compared to the anastomotic leak rate of 12.2% in the original study period from 2011 to 2014 (p = 0.07). Anastomotic leak rate for the entire patient series was 8.5%. A grade 2 anastomosis was associated with higher anastomotic leak rate compared to a grade 1 anastomosis (35.7% vs. 7.4%, p < 0.05). None of the five grade 3 anastomoses resulted in an anastomotic leak upon revision.

conclusionThis study further validates the anastomotic grading score and suggests that its systematic implementation can result in a reduction in anastomotic leaks.

Indexed as

Anastomotic LeakColorectal NeoplasmsAnastomosis, SurgicalFollow-Up StudiesHumansIschemiaRetrospective StudiesAnastomotic leakIntraoperative endoscopyMucosal grading

Identifiers

PMID37184769
OpenAlexW4376610940

What OpenQuestion holds

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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.