Impact of intraoperative colonoscopy for anastomosis assessment after left-sided colorectal surgery: a meta-analysis

Paun BC, Cassie S, MacLean AR, Dixon E, Buie WD. Postoperative complications following surgery for rectal cancer. Ann Surg. 2010;251:807–18.

Article  PubMed  Google Scholar 

Yamada T, Matsuda A, Nishino T, Uehara K, Hagiwara N, Sakurazawa N, et al. Impact of extended prophylactic antibiotic administration on surgical site infections: a multicenter real-world data study. Surg Today. 2025;55:1953–65.

Article  PubMed  Google Scholar 

Zarnescu EC, Zarnescu NO, Costea R. Updates of risk factors for anastomotic leakage after colorectal surgery. Diagnostics (Basel). 2021;11(12):2382. https://doi.org/10.3390/diagnostics11122382.

Shogan BD, Carlisle EM, Alverdy JC, Umanskiy K. Do we really know why colorectal anastomoses leak? J Gastrointest Surg. 2013;17:1698–707.

Article  PubMed  Google Scholar 

Tsalikidis C, Mitsala A, Mentonis VI, Romanidis K, Pappas-Gogos G, Tsaroucha AK, et al. Predictive Factors for Anastomotic Leakage Following Colorectal Cancer Surgery: Where Are We and Where Are We Going? Curr Oncol. 2023;30:3111–37.

Article  PubMed  PubMed Central  Google Scholar 

Mirnezami A, Mirnezami R, Chandrakumaran K, Sasapu K, Sagar P, Finan P. Increased local recurrence and reduced survival from colorectal cancer following anastomotic leak: systematic review and meta-analysis. Ann Surg. 2011;253:890–9.

Article  PubMed  Google Scholar 

Ono R, Tominaga T, Nonaka T, Takamura Y, Oishi K, Hashimoto S, et al. Risk factors for anastomotic leakage and long-term outcomes after laparoscopic right colectomy: a multicenter study in a Japanese rural area. Surg Today. 2025;55:1609–20.

Article  PubMed  Google Scholar 

Goulder F. Bowel anastomoses: the theory, the practice and the evidence base. World J Gastrointest Surg. 2012;4:208–13.

Article  PubMed  PubMed Central  Google Scholar 

Ong SY, Tan ZZX, Teo NZ, Ngu JCY. Surgical considerations for the perfect colorectal anastomosis. J Gastrointest Oncol. 2023;14:2243–8.

Article  PubMed  PubMed Central  Google Scholar 

Vardhan S, Deshpande SG, Singh A, Aravind Kumar C, Bisen YT, Dighe OR. Techniques for diagnosing anastomotic leaks intraoperatively in colorectal surgeries: a review. Cureus. 2023;15:e34168.

PubMed  PubMed Central  Google Scholar 

Rudnicki Y, White I, Tiomkin V, Lahav L, Raguan B, Avital S. Intraoperative evaluation of colorectal anastomotic integrity: a comparison of air leak and dye leak tests. Tech Coloproctol. 2021;25:841–7.

Article  CAS  PubMed  Google Scholar 

Kryzauskas M, Degutyte AE, Abeciunas V, Lukenaite B, Jasiunas E, Poskus E, et al. Experimental Study of Mechanical Integrity Testing in Stapled Large Bowel: Methylene Blue Leak Test Is Not Inferior to Air Leak Test. Visc Med. 2021;37:189–97.

Article  PubMed  Google Scholar 

Richter RM, Littman L, Levowitz BS. Intraoperative fiberoptic colonoscopy. Localization of nonpalpable colonic lesions. Arch Surg. 1973;106:228.

Article  CAS  PubMed  Google Scholar 

Shibuya N, Matsuda T, Yamashita K, Hasegawa H, Yamamoto M, Kanaji S, et al. Clinical Significance of Intraoperative Colonoscopy for Anastomotic Assessment in Rectal Cancer Surgery. Anticancer Res. 2019;39:5761–5.

Article  PubMed  Google Scholar 

Yoo RN, Mun JY, Cho HM, Kye BH, Kim HJ. Assessment of colorectal anastomosis with intraoperative colonoscopy: its role in reducing anastomotic complications. Biomedicines. 2023;11(4):1162. https://doi.org/10.3390/biomedicines11041162.

Article  PubMed  PubMed Central  Google Scholar 

Yavuz R, Aras O, Ciyiltepe H, Dincer O, Kurklu O, Ozyurt E, et al. Is it necessary to endoscopically evaluate the anastomosis in robotic or laparoscopic surgical procedures for colorectal cancer? J Laparoendosc Adv Surg Tech A. 2025;35:118–23.

Article  PubMed  Google Scholar 

Kryzauskas M, Bausys A, Jakubauskas M, Valciukiene J, Makunaite G, Jasiunas E, et al. Intraoperative testing of colorectal anastomosis and the incidence of anastomotic leak: A meta-analysis. Med (Baltim). 2020;99:e23135.

Article  Google Scholar 

Lanthaler M, Biebl M, Mittermair R, Ofner D, Nehoda H. Intraoperative colonoscopy for anastomosis assessment in laparoscopically assisted left-sided colon resection: is it worthwhile? J Laparoendosc Adv Surg Tech A. 2008;18:27–31.

Article  PubMed  Google Scholar 

Shamiyeh A, Szabo K, Ulf Wayand W, Zehetner J. Intraoperative endoscopy for the assessment of circular-stapled anastomosis in laparoscopic colon surgery. Surg Laparosc Endosc Percutan Tech. 2012;22:65–7.

Article  PubMed  Google Scholar 

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.

Article  PubMed  PubMed Central  Google Scholar 

Otsuka T, Matsuyama K. Nippon Medical School’s ethical review processes for studies involving human subjects. J Nippon Med Sch. 2024;91:136–9.

Article  PubMed  Google Scholar 

Rahbari NN, Weitz J, Hohenberger W, Heald RJ, Moran B, Ulrich A, et al. Definition and grading of anastomotic leakage following anterior resection of the rectum: a proposal by the International Study Group of Rectal Cancer. Surgery. 2010;147:339–51.

Article  PubMed  Google Scholar 

Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg. 2003;73:712–6.

Article  PubMed  Google Scholar 

Balshem H, Helfand M, Schunemann HJ, Oxman AD, Kunz R, Brozek J, et al. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol. 2011;64:401–6.

Article  PubMed  Google Scholar 

Yang SY, Han J, Han YD, Cho MS, Hur H, Lee KY, et al. Intraoperative colonoscopy for the assessment and prevention of anastomotic leakage in low anterior resection for rectal cancer. Int J Colorectal Dis. 2017;32:709–14.

Article  PubMed  Google Scholar 

Ma JJ, Ling TL, Lu AG, Zong YP, Feng B, Liu XY, et al. Endoscopic management for the assessment and treatment of anastomotic bleeding in laparoscopic anterior resection for rectal cancer. Surg Laparosc Endosc Percutan Tech. 2014;24:465–9.

Article  CAS  PubMed  Google Scholar 

Lieto E, Orditura M, Castellano P, Pinto M, Zamboli A, De Vita F, et al. Endoscopic intraoperative anastomotic testing may avoid early gastrointestinal anastomotic complications. A prospective study. J Gastrointest Surg. 2011;15:145–52.

Article  PubMed  Google Scholar 

Castano R, Molina-Meneses SP, Puerta JD, Palacios LJ, Jaramillo R, Pineres A, et al. Impact of intraoperative colonoscopy on anastomotic leakage detection and prevention in colorectal anastomosis for rectal cancer. Rev Gastroenterol Mex (Engl Ed). 2022;87:312–9.

CAS  PubMed  Google Scholar 

Kishiki T, Kojima K, Aso N, Iioka A, Wakamatsu T, Kataoka I, et al. Intraoperative Colonoscopy in Laparoscopic Rectal Cancer Surgery Reduces Anastomotic Leakage. J Anus Rectum Colon. 2022;6:159–67.

Article  PubMed  PubMed Central  Google Scholar 

Liu ZH, Liu JW, Chan FS, Li MK, Fan JK. Intraoperative colonoscopy in laparoscopic colorectal surgery: a review of recent publications. Asian J Endosc Surg. 2020;13:19–24.

Article  CAS  PubMed  Google Scholar 

Song SH, Park JS, Choi GS, Park SY, Kim HJ, Lee SM, et al. Efficacy of air leak test in detection of anastomotic leaks after rectal excision: a retrospective case-controlled study. Ann Surg Treat Res. 2023;104:214–21.

Article  PubMed  PubMed Central  Google Scholar 

Schwab R, Wessendorf S, Gutcke A, Becker P. Early bursting strength of human colon anastomoses–an in vitro study comparing current anastomotic techniques. Langenbecks Arch Surg. 2002;386:507–11.

Article  PubMed  Google Scholar 

Martinez-Perez A, Carra MC, Brunetti F, de’Angelis N. Short-term clinical outcomes of laparoscopic vs open rectal excision for rectal cancer: a systematic review and meta-analysis. World J Gastroenterol. 2017;23:7906–16.

Article  PubMed  PubMed Central  Google Scholar 

Park JS, Choi GS, Kim SH, Kim HR, Kim NK, Lee KY, et al. Multicenter analysis of risk factors for anastomotic leakage after laparoscopic rectal cancer excision: the Korean laparoscopic colorectal surgery study group. Ann Surg. 2013;257:665–71.

Article 

Comments (0)

No login
gif