AI Article Synopsis
- Until 2010, there was no widely accepted definition or severity grading system for anastomotic leakages (ALs) following rectal resection; the International Study Group of Rectal Cancer (ISGRC) established one that year.
- A systematic review of 930 abstracts identified 70 applicable studies, revealing an overall AL rate of 8.58% after anterior resection, with varying rates for different severity grades: 2.57% for asymptomatic (Grade A), 2.37% requiring intervention (Grade B), and 5.40% requiring relaparotomy (Grade C).
- The new grading system simplifies the classification of AL from existing literature,
Article Abstract
Background: A generally acceptable definition and a severity grading system for anastomotic leakages (ALs) following rectal resection were not available until 2010, when the International Study Group of Rectal Cancer (ISGRC) proposed a definition and a grading system for AL.
Methods: A search for published data was performed using the MEDLINE database (2000 to December 5, 2012) to perform a systematic review of the studies that described AL, grade AL according to the grading system, pool data, and determine the average rate of AL for each grade after anterior resection (AR) for rectal cancer.
Results: A total of 930 abstracts were retrieved; 40 articles on AR, 25 articles on low AR (LAR), and 5 articles on ultralow AR (ULAR) were included in the review and analysis. The pooled overall AL rate of AR was 8.58% (2,085/24,288); the rate of the asymptomatic leakage (Grade A) was 2.57%, that of AL that required active intervention without relaparotomy (Grade B) was 2.37%, and that of AL that required relaparotomy (Grade C) was 5.40%. The pooled rate of AL that required relaparotomy was higher in AR (5.40%) than in LAR (4.70%) and in ULAR (1.81%), which could be attributed to the higher rate of protective defunctioning stoma in LAR (40.72%) and ULAR (63.44%) compared with that in AR (30.11%).
Conclusions: The new grading system is simple that the ALs of each grade can be easily extracted from past publications, therefore likely to be accepted and applied in future studies.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3783382 | PMC |
| http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0075519 | PLOS |
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