{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T09:16:52Z","timestamp":1788513412344,"version":"build-2803163510"},"reference-count":64,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Anastomotic leakage (AL) impacts short\u2010term and long\u2010term outcomes after colorectal surgery, yet no consensus exists regarding its diagnosis and management. The aim was to establish a proactive consensus\u2010based approach for diagnosing and treating AL following rectal cancer surgery through a national survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A questionnaire was designed to assess 24 clinical scenarios related to the diagnosis and management of fistulas in low colorectal (LCA) or coloanal anastomosis (CAA) with a diverting ileostomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 203 surgeons from three surgical societies participated. Consensus was reached on four key indicators warranting further investigation of AL: CRP\u00a0&gt;\u00a0250\u00a0mg\/L, fever\u00a0\u2265\u00a038.5\u00b0C, tachycardia\u00a0&gt;\u00a0100\u00a0bpm, and diffuse abdominal pain. In the presence of any warning sign, 87% recommended an urgent contrast\u2010enhanced abdominopelvic CT scan without routine rectal contrast as the first\u2010line diagnostic tool. Isolated extra\u2010digestive air bubbles or uncollected effusions without air bubbles were managed with antibiotics (61%\u201378%). A perianastomotic collection required an anal examination under general anesthesia (70%). For treatment, transanal drainage (56%) was preferred over image\u2010guided percutaneous drainage, combined with endoluminal vacuum therapy and at least 7\u00a0days of antibiotics (97%). Drain removal was recommended (64%) when imaging confirmed the absence of residual collection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This national survey established a consensus\u2010driven proactive management algorithm for LCA\/CAA fistulas. Further validation controlled trial is needed to confirm the effectiveness in reducing AL\u2010related complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.12634","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T11:39:50Z","timestamp":1747827590000},"page":"1747-1756","source":"Crossref","is-referenced-by-count":5,"title":["Management of Low Colorectal\/Coloanal Anastomotic Leak: Results of a French National Intergroups Practice Survey (FRENCH\u2010GRECCAR\u2010SFCD)"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7736-3999","authenticated-orcid":false,"given":"Cl\u00e9ment","family":"Pastier","sequence":"first","affiliation":[{"name":"Department of Oncologic and Digestive Surgery Bic\u00eatre Hospital Assistance Publique\u2010 H\u00f4pitaux de Paris  Le Kremlin\u2010Bic\u00eatre France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wafa","family":"Ben 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