{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T16:08:53Z","timestamp":1789920533536,"version":"4.0.1"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2017,2,1]],"date-time":"2017-02-01T00:00:00Z","timestamp":1485907200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,2,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The effect of anastomotic leakage on oncological outcomes after total mesorectal excision (TME) is controversial. This study aimed to assess the influence of symptomatic and asymptomatic anastomotic leakage on oncological outcomes after laparoscopic TME.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>All patients who underwent restorative laparoscopic TME for rectal adenocarcinoma with curative intent from 2005 to 2014 were identified from an institutional database. Asymptomatic anastomotic leakage was defined by CT performed systematically 4\u20138 weeks after rectal surgery, with no relevant clinical symptoms or laboratory examination findings during the postoperative course.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of a total of 428 patients, anastomotic leakage was observed in 120 (28\u00b70 per cent) (50 asymptomatic, 70 symptomatic). After a mean follow-up of 40 months, local recurrence was observed in 36 patients (8\u00b74 per cent). Multivariable Cox regression identified three independent risk factors for reduced local recurrence-free survival (LRFS): symptomatic anastomotic leakage (odds ratio (OR) 2\u00b713, 95 per cent c.i. 1\u00b729 to 3\u00b750; P = 0\u00b7003), positive resection margin (R1) (OR 2\u00b741, 1\u00b740 to 4\u00b716; P = 0\u00b7001) and pT3\u20134 category (OR 1\u00b777, 1\u00b708 to 2\u00b790; P = 0\u00b7022). Patients with no risk factor for reduced LRFS had an estimated 5-year LRFS rate of 87\u00b77(s.d. 3\u00b72) per cent, whereas the rate dropped to 75\u00b73(4\u00b73) per cent with one risk factor, 67(7) per cent with two risk factors, and 14(13) per cent with three risk factors (P &amp;lt; 0\u00b7001). Asymptomatic anastomotic leakage was not significantly associated with LRFS in multivariable analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Symptomatic anastomotic leakage is a risk factor for disease recurrence in patients with rectal adenocarcinoma.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.10332","type":"journal-article","created":{"date-parts":[[2016,10,20]],"date-time":"2016-10-20T10:16:42Z","timestamp":1476958602000},"page":"288-295","source":"Crossref","is-referenced-by-count":75,"title":["Oncological impact of anastomotic leakage after laparoscopic mesorectal excision"],"prefix":"10.1093","volume":"104","author":[{"given":"E","family":"Hain","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery, Beaujon Hospital, Assistance Publique \u2013 H\u00f4pitaux de Paris, University Denis Diderot (Paris VII) , Clichy,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Maggiori","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Beaujon Hospital, Assistance Publique \u2013 H\u00f4pitaux de Paris, University Denis Diderot (Paris VII) , Clichy,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Manceau","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Beaujon Hospital, Assistance Publique \u2013 H\u00f4pitaux de Paris, University Denis Diderot (Paris VII) , Clichy,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Mongin","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Beaujon Hospital, Assistance Publique \u2013 H\u00f4pitaux de Paris, University Denis Diderot (Paris VII) , Clichy,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Prost \u00e0 la Denise","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Beaujon Hospital, Assistance Publique \u2013 H\u00f4pitaux de Paris, University Denis Diderot (Paris VII) , Clichy,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y","family":"Panis","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Beaujon Hospital, Assistance Publique \u2013 H\u00f4pitaux de Paris, University Denis Diderot (Paris VII) , Clichy,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,2,1]]},"reference":[{"key":"2024092914183050200_bjs10332-bib-0001","doi-asserted-by":"crossref","first-page":"1638","DOI":"10.1200\/JCO.2009.25.8376","article-title":"Comparison of two neoadjuvant chemoradiotherapy regimens for locally advanced rectal cancer: results of the phase III trial ACCORD 12\/0405-Prodige 2","volume":"28","author":"Gerard","year":"2010","journal-title":"J Clin Oncol"},{"key":"2024092914183050200_bjs10332-bib-0002","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/S1470-2045(11)70097-3","article-title":"Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial","volume":"12","author":"van Gijn","year":"2011","journal-title":"Lancet Oncol"},{"key":"2024092914183050200_bjs10332-bib-0003","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1097\/SLA.0000000000000979","article-title":"Toward the end of abdominoperineal resection for rectal cancer? 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