Observational studyColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland2026
Circular stapler platform and the risk of anastomotic leakage after elective left colectomy and high anterior resection.
Observational study in Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 1 paper.
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.
Anastomotic Leakage and Enhanced Recovery Pathways After Colorectal Surgery: the Italian ColoRectal Anastomotic Leakage Study Group (iCral 2)
Enhanced Recovery Pathways, Patient-reported Outcomes and Return to Intended Oncological Therapy After Colorectal Surgery: the Italian ColoRectal Anastomotic Leakage Study Group (iCral 3).
Enhanced Recovery and Patient Blood Management in Colorectal Surgery: the Italian ColoRectal Anastomotic Leakage Study Group (iCral 4).
Who cites it
1 citing paper in PubMed.
- Circular stapler platform and the risk of anastomotic leakage after elective left colectomy and high anterior resection.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026Observational
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimThe impact of different circular stapler platforms on the risk of anastomotic leakage following elective left colectomy and high anterior resection remains poorly defined. We compared the risk of anastomotic leakage across commonly used circular stapler platforms using advanced confounding control methods.
methodsThis pre-planned post hoc analysis pooled individual patient data from the published iCral-2 and iCral-3 studies and from the iCral-4 study, whose primary results are currently under peer review. Adults undergoing elective left colectomy or high anterior resection with standardized end-to-end circular stapled anastomosis were included. Five circular stapler platforms were compared. Confounding was addressed using generalized boosted model-based propensity score weighting targeting the average treatment effect on the treated, with doubly robust outcome modelling. The primary endpoint was overall anastomotic leakage at 60 days.
resultsAmong 3,653 patients, overall anastomotic leakage occurred in 2.7% of patients receiving the reference 3-row platform. After weighting, Platforms 3 and 4 were associated with a significantly increased risk of overall anastomotic leakage (odds ratios >2), whereas no statistically significant differences were observed for Platforms 2 or 5. Because the effective sample size after weighting was substantially reduced for Platform 3 owing to limited covariate overlap, the corresponding effect estimate should be interpreted with appropriate caution.
conclusionsSelected circular stapler platforms were associated with an increased risk of overall anastomotic leakage. These findings suggest platform-specific rather than class-wide differences and warrant confirmation in prospective studies designed to identify the device-related and procedural factors underlying these associations.
trial registrationNCT03771456 for iCral2, NCT04397627 for iCral3 and NCT05227014 for iCral4.
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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.