SynthesisInternational journal of surgery (London, England)2026
Risk and protective factors for postoperative anastomotic leakage in esophageal and gastrointestinal surgery: an umbrella review of meta-analyses and systematic reviews.
Synthesis in International journal of surgery (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
4 citing papers in PubMed.
- Development and internal validation of a prediction model for early anastomotic leak after minimally invasive esophagectomy: a prospective cohort study.Annals of medicine · 2026Article
- Ultra-early postoperative endoscopy reduces anastomotic leak after minimally invasive esophagectomy: a propensity score-matched study.Surgical endoscopy · 2026Article
- Securing the Achilles' Heel of Esophagectomy: An Updated Evidence-Based Roadmap for Anastomotic Leak Prevention.Cancers · 2026Review
- Construction and validation of a machine learning model for predicting anastomotic leak following radical esophagectomy for esophageal cancer.Frontiers in oncology · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectiveAnastomotic leakage (AL) is a common and serious complication in gastrointestinal surgery, which significantly affects patient recovery and long-term prognosis. This umbrella review aims to summarize the risk and protective factors for AL after gastric, esophageal, and colorectal cancer surgeries, and to provide a comprehensive evaluation of the quality of existing literature, offering guidance for clinical practice.
methodsA systematic search was conducted to identify eligible meta-analyses. For each included study, we recalculated and assessed the risk estimates, heterogeneity, small-study effects, excess significance testing, and publication bias. Additionally, we considered the quality of the studies and graded the evidence.
resultsA total of 173 potential associations were included. The analysis revealed that ASA scores (3-4), male gender, diabetes, hypertension, and chronic kidney disease were significantly associated with an increased risk of AL. Preoperative mechanical bowel preparation combined with oral antibiotics significantly reduced the incidence of AL. Intraoperative use of collagen or fibrin-based sealants, indocyanine green (ICG) fluorescence imaging, flexible endoscopic examination, and leak tests were all significantly associated with reduced AL risk. The use of nonsteroidal anti-inflammatory drugs (NSAIDs) was linked to an increased risk of AL. In rectal cancer surgeries, low-anterior resection was associated with a significantly higher risk of AL. In esophageal cancer surgeries, the incidence of AL was higher after transthoracic anastomosis than after cervical anastomosis, although the severity of complications associated with cervical anastomoses was lower.
conclusionAL remains a major challenge in gastrointestinal surgery, and involves multiple risk factors. Optimizing perioperative management, refining intraoperative techniques, and judicious use of antibiotics and NSAIDs can significantly reduce the risk of AL. Future research should focus on high-quality, large-sample, multicenter studies to explore more effective prevention and treatment strategies.
Indexed as
Identifiers
What Socratic holds
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 Socratic graph.