{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T03:57:26Z","timestamp":1773287846971,"version":"3.50.1"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,2,14]],"date-time":"2025-02-14T00:00:00Z","timestamp":1739491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,2,14]],"date-time":"2025-02-14T00:00:00Z","timestamp":1739491200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100011769","name":"St. Olavs Hospital Universitetssykehuset i Trondheim","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011769","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NTNU Norwegian University of Science and Technology"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Tech Coloproctol"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anastomotic leakage is a common complication after low anterior resection for rectal cancer, often resulting in a permanent stoma. This study aimed to evaluate the effectiveness of early detection, sepsis control, and transanal repair in managing anastomotic leakage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective cohort study conducted from January 2018 to June 2022 at a Norwegian university hospital, patients undergoing resectional surgery for rectal cancer were assessed for anastomotic leaks. Early detection involved CT with rectal contrast and flexible endoscopy. Repair eligibility required involvement of less than half the anastomotic circumference and no ischemia or retraction of the colon. The cavity outside the anastomotic defect was cleaned using a catheter for intermittent irrigation or endoluminal vacuum therapy. A diverting stoma was created, and a transabdominal pelvic drain was inserted if not already present. Once sepsis was controlled and the cavity was clean, the defect was sutured using a transanal minimally invasive surgery access platform or an open transanal technique, based on anastomosis level. Healing was confirmed via computed tomography (CT) with rectal contrast and rigid proctoscopy before reversing diverting stomas, and again at 12\u00a0months. A supplementary video demonstrates the technique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 22 identified anastomotic leaks, 11 underwent transanal repair, resulting in healed anastomosis for nine patients and restored bowel continuity for eight. Among these, five reported major low anterior resection syndrome. Median hospital stay was 20\u00a0days, with no 90-day mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This anastomosis-preserving approach for treating anastomotic leakage shows promise, potentially preserving bowel function and reducing permanent stoma rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10151-024-03103-1","type":"journal-article","created":{"date-parts":[[2025,2,14]],"date-time":"2025-02-14T03:37:26Z","timestamp":1739504246000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Transanal repair of anastomotic leakage after oncologic low anterior resection: a prospective cohort"],"prefix":"10.1007","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0569-4104","authenticated-orcid":false,"given":"W.","family":"Lossius","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Stornes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T. E.","family":"Bernstein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Wibe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,2,14]]},"reference":[{"issue":"3","key":"3103_CR1","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1007\/s00384-020-03771-z","volume":"36","author":"NZ Ahmad","year":"2021","unstructured":"Ahmad NZ, Abbas MH, Khan SU, Parvaiz A (2021) A meta-analysis of the role of diverting ileostomy after rectal cancer surgery. Int J Colorectal Dis 36(3):445\u2013455","journal-title":"Int J Colorectal Dis"},{"issue":"7","key":"3103_CR2","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1007\/s10151-019-02028-4","volume":"23","author":"A Arezzo","year":"2019","unstructured":"Arezzo A, Migliore M, Chiaro P, Arolfo S, Filippini C, Di Cuonzo D et\u00a0al (2019) The REAL (REctal Anastomotic Leak) score for prediction of anastomotic leak after rectal cancer surgery. Tech Coloproctol 23(7):649\u2013663","journal-title":"Tech Coloproctol"},{"issue":"3","key":"3103_CR3","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1111\/codi.15997","volume":"24","author":"M Degiuli","year":"2022","unstructured":"Degiuli M, Elmore U, De Luca R, De Nardi P, Tomatis M, Biondi A et\u00a0al (2022) Risk factors for anastomotic leakage after anterior resection for rectal cancer (RALAR study): a nationwide retrospective study of the Italian society of surgical oncology colorectal cancer network collaborative group. Colorectal Dis 24(3):264\u2013276","journal-title":"Colorectal Dis"},{"issue":"1","key":"3103_CR4","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1007\/s00464-017-5679-6","volume":"32","author":"WAA Borstlap","year":"2018","unstructured":"Borstlap WAA, Musters GD, Stassen LPS, van Westreenen HL, Hess D, van Dieren S et\u00a0al (2018) Vacuum-assisted early transanal closure of leaking low colorectal anastomoses: the CLEAN study. Surg Endosc 32(1):315\u2013327","journal-title":"Surg Endosc"},{"issue":"3","key":"3103_CR5","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1007\/s10151-021-02556-y","volume":"26","author":"W Lossius","year":"2022","unstructured":"Lossius W, Stornes T, Bernstein TE, Wibe A (2022) Implementation of transanal minimally invasive surgery (TAMIS) for rectal neoplasms: results from a single centre. Tech Coloproctol 26(3):175\u2013180","journal-title":"Tech Coloproctol"},{"issue":"5","key":"3103_CR6","doi-asserted-by":"publisher","first-page":"922","DOI":"10.1097\/SLA.0b013e31824f1c21","volume":"255","author":"KJ Emmertsen","year":"2012","unstructured":"Emmertsen KJ, Laurberg S (2012) Low anterior resection syndrome score: development and validation of a symptom-based scoring system for bowel dysfunction after low anterior resection for rectal cancer. Ann Surg 255(5):922\u2013928","journal-title":"Ann Surg"},{"key":"3103_CR7","unstructured":"Helsedirektoratet (2023). Nasjonalt handlingsprogram med retningslinjer for diagnostikk behandling og oppf\u00f8lging av kreft i tykktarm og endetarm, 10th ed. https:\/\/www.helsedirektoratet.no\/retningslinjer\/kreft-i-tykktarm-og-endetarm-handlingsprogram. Accessed 1 August 2024"},{"issue":"7","key":"3103_CR8","first-page":"1031","volume":"44","author":"L Trenti","year":"2018","unstructured":"Trenti L, Galvez A, Biondo S, Solis A, Vallribera-Valls F, Espin-Basany E et\u00a0al (2018) Quality of life and anterior resection syndrome after surgery for mid to low rectal cancer: a cross-sectional study. Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol 44(7):1031\u20131039","journal-title":"Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol"}],"container-title":["Techniques in Coloproctology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10151-024-03103-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10151-024-03103-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10151-024-03103-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T09:58:46Z","timestamp":1766051926000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10151-024-03103-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,14]]},"references-count":8,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["3103"],"URL":"https:\/\/doi.org\/10.1007\/s10151-024-03103-1","relation":{},"ISSN":["1123-6337","1128-045X"],"issn-type":[{"value":"1123-6337","type":"print"},{"value":"1128-045X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,14]]},"assertion":[{"value":"14 August 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 December 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 February 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or nonfinancial interest in the subject matter or materials discussed in this manuscript. An abstract including the first eight patients in the current study was presented as an e-poster at the ASCRS Annual Scientific Meeting, Seattle, USA, 3\u20136 June 2023.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Patients suffering an anastomotic leakage treated by secondary transanal suture were asked to provide informed consent and completion of LARS surveys [\n                      \n                      ] with the assistance of a study nurse. Passive opt-out consent was provided by the remaining patients. The study was approved by the Regional Committee for Medical and Health Research Ethics Central Norway.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and Informed consent"}}],"article-number":"67"}}