SynthesisUpdates in surgery2025
Comprehensive evaluation of reinforcement strategies for anastomotic leak prevention in rectal cancer surgery: an umbrella review of meta-analyses.
Synthesis in Updates in surgery, 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.
What it found
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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.
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.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Novel adjunctive technologies for the prevention of colorectal anastomotic leakage: a systematic review.Techniques in coloproctology · 2026Pooled it
- Prevention and management of anastomotic leakage after colorectal resection: evolving trends among Italian surgeons. A SICCR survey.Updates in surgery · 2026Article
- Emergency Surgery and the Risk of Anastomotic Leakage After Colorectal Resection with Primary Anastomosis for Benign and Malignant Disease: A Single-Center Retrospective Study.Journal of clinical medicine · 2026Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Anastomotic leakage remains a serious complication following colorectal surgery. Various reinforcement techniques have been explored in literature, with multiple systematic reviews and meta-analyses addressing their effectiveness. However, no umbrella review has yet comprehensively synthesized this evidence. We aimed to summarize and critically appraise the available systematic reviews and meta-analyses investigating the effectiveness of anastomotic reinforcement techniques in colorectal surgery. A comprehensive literature search was conducted in PubMed, Embase, Scopus, and Cochrane Library up to June 2025. Eligible studies were systematic reviews or meta-analyses evaluating any reinforcement technique (biological, mechanical, or chemical) in colorectal anastomoses. Data extraction included review characteristics, reinforcement strategies, primary outcomes (anastomotic leak), and methodological quality assessed using AMSTAR 2. Twenty-one systematic reviews and meta-analyses were included. The reinforcement strategies evaluated comprised transanal tube (TAT) placement, suture reinforcement, and omentoplasty. Most reviews showed a reduction in anastomotic leak rates, particularly with TAT (43-70%) and sutures (59-75%), with the most pronounced effect observed in patients without a diverting stoma. TAT was also associated with a reduction in reintervention rates (62-84%). Findings on hospital stay were inconsistent, while no significant effects were reported for anastomotic bleeding, infections, stenosis, or mortality. The overall methodological quality of the included studies was rated as critically low. TAT and reinforcement sutures show potential in reducing anastomotic leakage in colorectal surgery. However, significant heterogeneity and variable methodological quality across reviews limit definitive conclusions. High-quality, targeted studies and standardized outcome definitions are warranted.
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Registered trials
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.