{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T11:03:59Z","timestamp":1769511839813,"version":"3.49.0"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,1,4]],"date-time":"2024-01-04T00:00:00Z","timestamp":1704326400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Anastomotic leakage is a serious complication following surgery for cancer of the rectum. It is not clear whether reinforcing sutures could prevent anastomotic leakage. Therefore, this study aims at evaluating the efficacy of reinforcing sutures on anastomotic leakage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched PubMed, Embase, and the Cochrane Library databases from inception to January 31, 2023. We included studies comparing anastomosis with reinforcing sutures to anastomosis without reinforcing sutures after low anterior resection. Risk of bias was assessed by the Cochrane tool for RCTs and the Risk of Bias in Non\u2010Randomized Studies (ROBINS)\u2010I tool for observational studies. The overall quality of evidence for primary outcome was assessed using Grading of Recommendations Assessment, Development, and Evaluations methodology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two RCTs (345 patients) and four observational studies (783 patients) were included. Anastomotic leakage occurred in 4.4% (24 of 548) of patients with reinforcing sutures and 11.9% (69 of 580) of patients without reinforcing sutures. Meta\u2010analysis showed a lower incidence of anastomotic leakage (RR, 0.41; 95% CI 0.25 to 0.66, low certainty) in patients with reinforcing sutures. Operative time (WMD, \u22123.66; 95% CI \u221218.58 to 11.25) and reoperation for anastomotic leakage (RR, 0.69; 95% CI 0.23 to 2.08) were similar between patients with reinforcing sutures and those without reinforcing sutures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>While observational data suggest that, there is a clear benefit in terms of reducing the risk of anastomotic leakage with the use of reinforcing sutures, RCT data are less clear. Further large, prospective studies are warranted to determine whether a true clinically important benefit exists with this technique.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cnr2.1941","type":"journal-article","created":{"date-parts":[[2024,1,4]],"date-time":"2024-01-04T10:19:02Z","timestamp":1704363542000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Efficacy of reinforcing sutures for prevention of anastomotic leakage after low anterior resection for rectal cancer: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5439-3482","authenticated-orcid":false,"given":"Shuanhu","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal surgery The First Affiliated Hospital of Bengbu Medical College  Bengbu Anhui China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal surgery The First Affiliated Hospital of Bengbu Medical College  Bengbu Anhui China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Song","family":"Tao","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal surgery The First Affiliated Hospital of Bengbu Medical College  Bengbu Anhui China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yakui","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal surgery The First Affiliated Hospital of Bengbu Medical College  Bengbu Anhui China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal surgery The First Affiliated Hospital of Bengbu Medical College  Bengbu Anhui China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiajia","family":"Guan","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal surgery The First Affiliated Hospital of Bengbu Medical College  Bengbu Anhui China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mulin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal surgery The First Affiliated Hospital of Bengbu Medical College  Bengbu Anhui China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,1,4]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.1003854"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-022-02609-2"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.5387\/fms.2019-17"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000005647"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-016-3761-1"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2015.11.006"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-022-04283-8"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000019437"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2021.4568"},{"key":"e_1_2_9_12_1","first-page":"491","article-title":"Intracorporeal reinforcing sutures reduce anastomotic leakage in double\u2010stapling anastomosis for laparoscopic rectal surgery","volume":"17","author":"Hashida H","year":"2022","journal-title":"Wideochir Inne Tech Maloinwazyjne"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000065"},{"key":"e_1_2_9_14_1","unstructured":"HigginsJPT ThomasJ ChandlerJ et al.Cochrane Handbook for Systematic Reviews of Interventions version 6.3 (updated February 2022). 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