ReviewSurgery in practice and science2026
No significant association between perioperative serum sodium and intestinal anastomotic leaks: a systematic review and meta-analysis.
Review in Surgery in practice and science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
6 authors.
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Abstract
Background: Anastomotic leakage (AL) rates have been reported as high as 40% with associated mortality approaching 27%. Non-osmotic activation of vasopressin may result in hyponatremia. It has been suggested that perioperative sodium changes may function as an inexpensive and widely available biomarker for early identification of AL. Methods: A systematic review and meta-analysis was performed, registered with PROSPERO (CRD42024522436). English language observational studies were eligible regardless of publication date. Methodological quality was evaluated using the QUADAS 2 tool. Quantitative synthesis was conducted using Meta Mar version 3.5.1. Results: Among 121 screened records, five studies fulfilled the inclusion criteria. One study demonstrated a high risk of bias related to patient selection, while the remaining studies were assessed as low risk across all evaluated domains. The combined cohort included 2034 patients, with AL occurring in 188 individuals (9%). Although all studies measured preoperative serum sodium, only three reported these values, and three studies assessed postoperative sodium levels. Pooled analysis showed no statistically significant differences in preoperative (SMD -0.45, Conclusions: Current evidence does not demonstrate a statistically significant association between perioperative serum sodium levels and anastomotic leakage. While individual studies have suggested a potential relationship, the substantial heterogeneity and methodological limitations limit the reliability of these findings. Further well-designed prospective studies are required before serum sodium can be considered a clinically useful biomarker.
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