SynthesisColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland2025
Preoperative anastomotic evaluation prior to ileostomy closure: A 5-year UK survey, systematic review, and meta-analysis.
Synthesis in Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Preoperative anastomotic evaluation prior to ileostomy closure: A 5-year UK survey, systematic review, and meta-analysis.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025Pooled it
- Prevention, Recognition, and Management of Anastomotic Leakage and Pelvic Sepsis After Rectal Cancer Surgery: A Structured Narrative Review.Journal of clinical medicine · 2026Review
- Ileostoma as a promising tool in pathophysiological study and clinical intervention: a review from bench to beside.Frontiers in immunology · 2026Review
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimTo compare current UK surgical practice against evidence-based anastomotic evaluation techniques prior to ileostomy closure.
methodsAn online survey was distributed to UK consultant colorectal surgeons with Association of Coloproctology of Great Britain and Ireland affiliation to assess preoperative investigations. Data were collected at two timepoints: 2019 and 2024. A systematic review and meta-analysis were performed utilising PRISMA guidelines. MEDLINE (PubMed), Embase and Education Resources Information Center databases were evaluated from inception to 27 March 2024. Inclusion criteria were adult patients (≥18 years), distal colonic/pelvic anastomosis and defunctioning ileostomy reversal. ROBINS-I bias assessments were conducted. DerSimonian and Laird random-effects analyses were performed on eligible sensitivity and specificity data with forest plots generated. PROSPERO ID: CRD42024520236.
resultsThe survey received 221 (41.0%) and 212 (40.7%) responses in 2019 and 2024 respectively. Pre- and post-pandemic practice was consistent. Water-soluble contrast enema (WCE) and digital rectal examination (DRE) were the most utilised, performed 'always' by 83.2% and 78.7% respectively. Thirty-seven studies (5061 patients) were included for systematic review; 12 studies (1385 patients) for meta-analysis. Studies were heterogeneous in methodology; no randomised controlled trials were identified. Endoscopy showed higher sensitivity (73.1%) compared to retrograde contrast studies (WCE and pouchography; 53.1%) in identifying anastomotic leaks. Specificity was similar: 100% and 98.0% respectively. Significant heterogeneity and a lack of eligible studies limited further interpretation. CT has a limited evidence base for anastomotic evaluation.
conclusionsThe most commonly performed anastomotic evaluation methods in the UK are WCE and DRE. Endoscopy, however, has a greater sensitivity and specificity for identifying anastomotic complications. WCE is an effective option to confirm suspected leaks. Endoscopy should be considered to evaluate anastomotic integrity prior to ileostomy closure.
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