ArticleWorld journal of surgery2026
Impact of an ERAS-Based Surgical Care Bundle Implementation for Preventing Anastomotic Leakage in Minimally Invasive Low Anterior Resection for Rectal Cancer: A Retrospective Cohort Study.
Article in World journal of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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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Who cites it
1 citing paper in PubMed.
- Invited Commentary: Reducing the Risk of Anastomotic Leak After Rectal Cancer Resection.World journal of surgery · 2026Article
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10 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundAnastomotic leakage (AL) remains a severe complication after low anterior resection (LAR) for rectal cancer, despite advances in minimally invasive (MI) techniques. This study aimed to evaluate the impact of a surgery-focused care bundle, implemented on an enhanced recovery after surgery (ERAS)-based perioperative protocol, on preventing AL and improving postoperative outcomes in patients with MI-LAR.
methodsIn this retrospective historically controlled cohort study, a total of 306 patients who underwent MI-LAR between 2011 and 2024 were included. A late-phase cohort (n = 81) receiving the care bundle with an ERAS-based protocol (from September 2019) was compared with a historical early-phase cohort (n = 225). The surgery-focused care bundle included robot surgery, preoperative oral antibiotics, indocyanine green blood flow evaluation, diverting stoma, transanal drainage tubes, and anastomotic reinforcement. Our institutional ERAS protocol was developed in accordance with the ERAS Society guidelines. Propensity score matching (PSM) was used to adjust for baseline differences between cohorts.
resultsThe AL rate significantly decreased from 14.7% (33/225) to 2.5% (2/81) after bundle implementation (p < 0.01). Post-PSM, AL rates remained significantly lower in the late-phase cohort (18.0% vs. 1.3% and p < 0.001). Severe complications (Clavien-Dindo grade ≥ 3) and surgical site infections (SSIs) were also significantly reduced, and no reoperations were required in the late-phase cohort. Multivariate analysis identified lack of care bundle (odds ratio [OR]: 6.36, 95% confidence interval [CI]: 1.42-28.4, and p = 0.01) and male sex (OR: 3.05, 95% CI: 1.24-7.52, and p = 0.01) as significant risk factors for AL.
conclusionsImplementation of a surgery-focused care bundle, integrated within an ERAS-based perioperative framework, significantly reduced AL, severe complications, and SSIs after MI-LAR, suggesting potential long-term benefits by improving short-term postoperative outcomes.
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