Danique J I Heuvelings, Omar Mollema, Sander M J van Kuijk, Merel L Kimman, Marylise Boutros, Nader Francis, Nicole D Bouvy, Patricia Sylla
{"title":"Quality of Reporting on Anastomotic Leaks in Colorectal Cancer Trials: A Systematic Review.","authors":"Danique J I Heuvelings, Omar Mollema, Sander M J van Kuijk, Merel L Kimman, Marylise Boutros, Nader Francis, Nicole D Bouvy, Patricia Sylla","doi":"10.1097/DCR.0000000000003475","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Although attempts have been made in the past to establish consensus regarding the definitions and grading of the severity of colorectal anastomotic leakage, widespread adoption has remained limited.</p><p><strong>Objective: </strong>A systematic review of the literature was conducted to examine the various elements used to report and define anastomotic leakage in colorectal cancer resections.</p><p><strong>Data sources: </strong>A systematic review was conducted using the PubMed, Embase, and Cochrane Library Database.</p><p><strong>Study selection: </strong>All published randomized controlled trials, systematic reviews, and meta-analyses containing data related to adult patients undergoing colorectal cancer surgery and reporting anastomotic leakage as a primary or secondary outcome, with a definition of anastomotic leakage were included.</p><p><strong>Main outcome measures: </strong>Definitions of anastomotic leakage, clinical symptoms, radiological modalities and findings, findings at reoperation, and grading terminology or classifications for anastomotic leakage.</p><p><strong>Results: </strong>Of the 471 articles reporting anastomotic leakage as a primary or secondary outcome, a definition was reported in 95 studies (45 randomized controlled trials, 13 systematic reviews, and 37 meta-analyses) involving a total of 346,140 patients. Of these 95 articles, 68% reported clinical signs and symptoms of anastomotic leakage, 26% biochemical criteria, 63% radiological modalities, 62% radiological findings, and 13% findings at reintervention. Only 45% (n = 43) of included studies reported grading of anastomotic leakage severity or leak classification, and 41% (n = 39) included a time frame for reporting.</p><p><strong>Limitations: </strong>There was a high level of heterogeneity between the included studies.</p><p><strong>Conclusions: </strong>This evidence synthesis confirmed incomplete and inconsistent reporting of anastomotic leakage across the published colorectal cancer literature. There is a great need to develop and implement a consensus framework for defining, grading, and reporting anastomotic leakage.</p><p><strong>Registration: </strong>Prospectively registered at PROSPERO (ID 454660).</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"1383-1401"},"PeriodicalIF":3.2000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11477855/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diseases of the Colon & Rectum","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/DCR.0000000000003475","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/7 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Although attempts have been made in the past to establish consensus regarding the definitions and grading of the severity of colorectal anastomotic leakage, widespread adoption has remained limited.
Objective: A systematic review of the literature was conducted to examine the various elements used to report and define anastomotic leakage in colorectal cancer resections.
Data sources: A systematic review was conducted using the PubMed, Embase, and Cochrane Library Database.
Study selection: All published randomized controlled trials, systematic reviews, and meta-analyses containing data related to adult patients undergoing colorectal cancer surgery and reporting anastomotic leakage as a primary or secondary outcome, with a definition of anastomotic leakage were included.
Main outcome measures: Definitions of anastomotic leakage, clinical symptoms, radiological modalities and findings, findings at reoperation, and grading terminology or classifications for anastomotic leakage.
Results: Of the 471 articles reporting anastomotic leakage as a primary or secondary outcome, a definition was reported in 95 studies (45 randomized controlled trials, 13 systematic reviews, and 37 meta-analyses) involving a total of 346,140 patients. Of these 95 articles, 68% reported clinical signs and symptoms of anastomotic leakage, 26% biochemical criteria, 63% radiological modalities, 62% radiological findings, and 13% findings at reintervention. Only 45% (n = 43) of included studies reported grading of anastomotic leakage severity or leak classification, and 41% (n = 39) included a time frame for reporting.
Limitations: There was a high level of heterogeneity between the included studies.
Conclusions: This evidence synthesis confirmed incomplete and inconsistent reporting of anastomotic leakage across the published colorectal cancer literature. There is a great need to develop and implement a consensus framework for defining, grading, and reporting anastomotic leakage.
Registration: Prospectively registered at PROSPERO (ID 454660).
期刊介绍：
Diseases of the Colon & Rectum (DCR) is the official journal of the American Society of Colon and Rectal Surgeons (ASCRS) dedicated to advancing the knowledge of intestinal disorders by providing a forum for communication amongst their members. The journal features timely editorials, original contributions and technical notes.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
