Evidence map›Paper›PMID 38767835›Full record

ArticleUpdates in surgery2024

Intraoperative left-sided colorectal anastomotic testing in clinical practice: a multi-treatment machine-learning analysis of the iCral3 prospective cohort.

Marco Catarci, Stefano Guadagni, Francesco Masedu, Gianluca Guercioni, Giacomo Ruffo, Massimo Giuseppe Viola, Felice Borghi, Marco Scatizzi, Alberto Patriti, Gian Luca Baiocchi and 1 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Updates in surgery, 2024. 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
–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

1 citing paper in PubMed.

  1. 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

11 authors.

Marco CatarciGeneral Surgery Unit, Sandro Pertini Hospital, ASL Roma 2, Via dei Monti Tiburtini, 385, 00157, Rome, Italy. marco.catarci@aslroma2.it.ORCID http://orcid.org/0000-0002-6338-0114
Stefano GuadagniGeneral Surgery Unit, University of L'Aquila, L'Aquila, Italy.
Francesco MaseduDepartment of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy.
Gianluca GuercioniGeneral Surgery Unit, "C. E G. Mazzoni" Hospital, Ascoli Piceno, Italy.
Giacomo RuffoGeneral Surgery Unit, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, VR, Italy.
Massimo Giuseppe ViolaGeneral Surgery Unit, Cardinale G. Panico Hospital, Tricase, LE, Italy.
Felice BorghiOncologic Surgery Unit, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, TO, Italy.
Marco ScatizziGeneral Surgery Unit, Santa Maria Annunziata & Serristori Hospital, Florence, Italy.
Alberto PatritiDepartment of Surgery, S. Salvatore Hospital, AST Marche 1, Pesaro e Fano, PU, Italy.
Gian Luca BaiocchiGeneral Surgical Unit, Department of Clinical and Experimental Sciences, University of Brescia at the ASST Cremona, Cremona, Italy.
Italian ColoRectal Anastomotic Leakage (iCral) study group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCurrent evidence about intraoperative anastomotic testing after left-sided colorectal resections is still controversial. The aim of this study was to analyze the impact of Indocyanine Green fluorescent angiography (ICG-FA) and air-leak test (ALT) over standard assessment on anastomotic leakage (AL) rates according to surgeon's perception of anastomosis perfusion and/or integrity in clinical practice.

methodsA database of 2061 patients who underwent left-sided colorectal resections was selected from patients enrolled in a prospective multicenter study. It was retrospectively analyzed through a multi-treatment machine-learning model considering standard visual assessment (NW; No. = 899; 43.6%) as the reference treatment arm, compared to ICG-FA alone (WP; No. = 409; 19.8%), ALT alone (WI; No. = 420; 20.4%) or both (WPI; No. = 333; 16.2%). Twenty-four covariates potentially affecting the outcomes were included and balanced into the model within the subgroups. The primary endpoint was AL, the secondary endpoints were overall morbidity (OM), major morbidity (MM), reoperation for AL, and mortality. All the results were reported as odds ratio (OR) with 95% confidence intervals (95%CI).

resultsThe WPI subgroup showed significantly higher AL risk (OR 1.91; 95% CI 1.02-3.59; p 0.043), MM risk (OR 2.35; 95% CI 1.39-3.97; p 0.001), and reoperation for AL risk (OR 2.44; 95% CI 1.12-5.31; p 0.025). No other significant differences were recorded.

conclusionsThis study showed that the surgeons' perception of both anastomotic perfusion and integrity (WPI subgroup) was associated to a significantly higher risk of AL and related morbidity, notwithstanding the extensive use of both ICG-FA and ALT testing.

Indexed as

Anastomosis, SurgicalAnastomotic LeakIndocyanine GreenMachine LearningAgedCohort StudiesColonFemaleFluorescein AngiographyHumansIntraoperative CareMaleMiddle AgedProspective StudiesRectumReoperationIndocyanine GreenAir-leak testAnastomotic leakageColorectal surgeryICG fluorescent angiographyLeft-sided colorectal resection

Identifiers

PMID38767835

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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.