Evidence map›Paper›PMID 41578375›Full record

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.

Koji Tamura, Takaaki Fujimoto, Jinghui Zhang, Kinuko Nagayoshi, Yusuke Mizuuchi, Kohei Horioka, Naoki Ikenaga, Kohei Nakata, Kenoki Ohuchida, Masafumi Nakamura

Abstract read
In one paragraph

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.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Koji TamuraDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.ORCID https://orcid.org/0000-0003-2500-8810
Takaaki FujimotoDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Jinghui ZhangDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Kinuko NagayoshiDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.ORCID https://orcid.org/0000-0003-4293-3610
Yusuke MizuuchiDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Kohei HoriokaDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Naoki IkenagaDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.ORCID https://orcid.org/0009-0003-6285-6883
Kohei NakataDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.ORCID https://orcid.org/0000-0002-5717-8569
Kenoki OhuchidaDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Masafumi NakamuraDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

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.

Indexed as

Anastomotic LeakEnhanced Recovery After SurgeryMinimally Invasive Surgical ProceduresPatient Care BundlesRectal NeoplasmsAgedColorectal Surgical ProceduresFemaleHumansMaleMiddle AgedPropensity ScoreRetrospective StudiesRobotic Surgical Proceduresanastomotic leakagelaparoscopic surgerylow anterior resectionrectal cancerrobot‐assisted surgery

Identifiers

PMID41578375
PMCPMC13006784

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.