Radiotherapy as a potential risk factor for delayed anastomotic leakage after rectal surgery: a meta-analysis.

Jau-Jie You, Abe Fingerhut, Yi-Chang Chen, William Tzu-Liang Chen, Ming-Yin Shen

Abstract readMeta-AnalysisSystematic Review

In one paragraph

Synthesis in BMC surgery, 2025. 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.

The Essential Role of High-resolution MRI Fistulogram Imaging with Ultrasound Gel Enema in Diagnosing Complex Rectovaginal Fistulas Post-Chemoradiation for Rectal Cancer: A Case Study Review.Current medical imaging · 2026
Review

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

5 authors.

Jau-Jie YouDepartment of Colorectal Surgery, China Medical University Hsinchu Hospital, No. 199, Sec. 1, Xinglong Rd., Zhubei, Hsinchu, 302, Taiwan.ORCID http://orcid.org/0009-0009-2395-6295

Abe FingerhutCollege of Medicine, China Medical University, Taichung, 404, Taiwan.ORCID http://orcid.org/0000-0003-4243-9196

Yi-Chang ChenInstitute of Medicine, Chung Shan Medical University, Taichung, 402, Taiwan.ORCID http://orcid.org/0000-0003-2958-6773

William Tzu-Liang ChenDepartment of Colorectal Surgery, China Medical University Hsinchu Hospital, No. 199, Sec. 1, Xinglong Rd., Zhubei, Hsinchu, 302, Taiwan.ORCID http://orcid.org/0000-0002-6585-2437

Ming-Yin ShenDepartment of Colorectal Surgery, China Medical University Hsinchu Hospital, No. 199, Sec. 1, Xinglong Rd., Zhubei, Hsinchu, 302, Taiwan. mingyin.shen@gmail.com.ORCID http://orcid.org/0000-0003-0978-908X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRadiotherapy is a well-recognized risk factor of acute leakage after colorectal surgery. However, its relationship with delayed leakage remains unclear. The aim of this systemic review and meta-analysis was to determine its association with delayed anastomotic leakage (DAL) after rectal surgery.

methodsA comprehensive literature search was conducted across seven international databases (PubMed, Embase, Cochrane CENTRAL, ClinicalKeys, EBSCOhost-CINAHL, Web of Science, and Google Scholar), five Chinese/Taiwanese databases, the ProQuest Dissertations, and three Grey literature databases. All studies that reported DAL where radiotherapy and nonradiotherapy study groups were included. The random-effect model was used to combine data. Data were presented as odds-ratios (ORs) with 95% confidence intervals (CI). The main outcome measured was DAL.

resultsSix comparative series involving a total of 4991 patients were analyzed. DAL was identified in 323 cases, occurring between 22 and 2059 days post-operation. The results revealed a statistically significant increase in the risk of DAL following radiotherapy (OR = 5.208; 95% CI = 3.241-8.371; p < 0.001). Heterogeneity was observed across the included studies (Cochran Q = 12.769 (p=0.026), I2=60.844%, Tau2 = 0.188, predictive interval (PI) = 5.208, 95% PI = 1.313-20.665).

conclusionsRadiotherapy is a potential risk factor for DAL after anterior resection and low anterior resection.

Indexed as

Anastomotic LeakRadiotherapyRectal NeoplasmsRectumColorectal Surgical ProceduresHumansRisk FactorsTime FactorsAnterior resectionDelayed leakageLow anterior resectionRadiotherapy

Identifiers

PMID41126092

DOI10.1186/s12893-025-03247-3

PMCPMC12542160

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LicenceCC BY-NC-ND

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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.