Evidence map›Paper›PMID 37816844›Full record

Observational studyLangenbeck's archives of surgery2023

Does anastomotic leakage after intersphincteric resection for ultralow rectal cancer influence long-term outcomes? A retrospective observational study.

Feifan Liu, Bin Zhang, Jianbin Xiang, Guangzuan Zhuo, Yujuan Zhao, Yiming Zhou, Jianhua Ding

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Langenbeck's archives of surgery, 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
–field-weighted citation impact
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.

  1. Article
  2. Article
  3. 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

7 authors.

Feifan Liu *Postgraduate Training Base of Jinzhou Medical University, the Characteristic Medical Center of PLA Rocket Force, Beijing, 100088, China.
Bin Zhang *Department of Colorectal Surgery, the Characteristic Medical Center of PLA Rocket Force, Beijing, 100088, China.
Jianbin Xiang *Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China.
Guangzuan ZhuoDepartment of Colorectal Surgery, the Characteristic Medical Center of PLA Rocket Force, Beijing, 100088, China.
Yujuan ZhaoDepartment of Colorectal Surgery, the Characteristic Medical Center of PLA Rocket Force, Beijing, 100088, China.
Yiming ZhouDepartment of General Surgery, Huashan Hospital, Fudan University, Shanghai, China.
Jianhua DingDepartment of Colorectal Surgery, the Characteristic Medical Center of PLA Rocket Force, Beijing, 100088, China. jianhuading75@163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo determine whether anastomotic leakage (AL) following intersphincteric resection (ISR) for ultralow rectal cancer (uLRC) is associated with long-term negative outcomes.

methodsBetween June 2011 and January 2022, 236 consecutive patients who underwent ISR with diverting ileostomy for uLRC were included. The primary outcome was long-term clinical consequences of AL, including chronic stricture, stoma reversal, and oncological and functional results.

resultsForty-one (17.4%) patients developed symptomatic AL, whereas only two (0.8%) required re-laparotomy due to severe leakage. Patients with leaks had a significantly increased incidence of chronic stricture (29.3% vs. 8.7%, P = 0.001) and stoma non-reversal (34.1% vs. 4.6%, P < 0.0001) than controls. The severe consequences were particularly common in patients with anastomotic separation, resulting in 60% of those presenting with chronic stricture and 50% ending up with stoma non-reversal. After a median follow-up of 59 (range, 7-139) months, AL did not compromise long-term oncological outcomes, including tumor recurrence (9.8% vs. 5.6%, P = 0.3), 5-year disease-free, and overall survival (73.4% vs. 74.8% and 85.1% vs. 85.4%, P = 0.56 and P = 0.55). A total of 149 patients with bowel continuity who completed self-assessment questionnaires were enrolled for functional evaluation. The median follow-up was 24 (range, 12-94) months after ileostomy reversal, and functional results were comparable between patients with and without leaks.

conclusionAL is an unfortunate reality for patients who underwent ISR for uLRC, but the rate of severe leakage is limited. Leaks contribute to possible adverse impacts on chronic stricture and stoma non-reversal, especially for patients with anastomotic separation. However, long-term oncological and functional results may not be compromised.

trial registrationChictr.org.cn identifier: ChiCTR-ONC-15007506 and ChiCTR2100051614.

Indexed as

Anastomotic LeakRectal NeoplasmsAnal CanalAnastomosis, SurgicalConstriction, PathologicHumansNeoplasm Recurrence, LocalRetrospective StudiesAnastomotic leakageIntersphincteric resectionLong-term outcomesUltralow rectal cancer

Identifiers

PMID37816844

What OpenQuestion holds

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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.