{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T22:47:42Z","timestamp":1793314062266,"version":"4.5.0"},"reference-count":43,"publisher":"Elsevier BV","issue":"6","license":[{"start":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T00:00:00Z","timestamp":1685577600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T00:00:00Z","timestamp":1685577600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T00:00:00Z","timestamp":1685577600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T00:00:00Z","timestamp":1685577600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T00:00:00Z","timestamp":1685577600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T00:00:00Z","timestamp":1685577600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T00:00:00Z","timestamp":1685577600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","surgjournal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Surgery"],"published-print":{"date-parts":[[2023,6]]},"DOI":"10.1016\/j.surg.2023.02.018","type":"journal-article","created":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T09:29:54Z","timestamp":1679650194000},"page":"1367-1373","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":42,"title":["Single-stapled anastomosis is associated with a lower anastomotic leak rate than double-stapled technique after minimally invasive total mesorectal excision for MRI-defined low rectal cancer"],"prefix":"10.1016","volume":"173","author":[{"given":"Caterina","family":"Foppa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Carvello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7576-9629","authenticated-orcid":false,"given":"Annalisa","family":"Maroli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Sacchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Gramellini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Montorsi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1493-1768","authenticated-orcid":false,"given":"Antonino","family":"Spinelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.surg.2023.02.018_bib1","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1046\/j.1365-2168.2001.01719.x","article-title":"Outcome and late functional results after anastomotic leakage following mesorectal excision for rectal cancer","volume":"88","author":"Nesbakken","year":"2000","journal-title":"Br J Surg"},{"key":"10.1016\/j.surg.2023.02.018_bib2","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1097\/SLA.0b013e3182128929","article-title":"Increased local recurrence and reduced survival from colorectal cancer following anastomotic leak: systematic review and meta-analysis","volume":"253","author":"Mirnezami","year":"2011","journal-title":"Ann Surg"},{"key":"10.1016\/j.surg.2023.02.018_bib3","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1016\/j.ejso.2020.02.027","article-title":"Anastomotic leak in colorectal cancer patients: new insights and perspectives","volume":"46","author":"Foppa","year":"2020","journal-title":"Eur J Surg Oncol"},{"key":"10.1016\/j.surg.2023.02.018_bib4","doi-asserted-by":"crossref","first-page":"O1","DOI":"10.1111\/codi.13534","article-title":"A\u00a0collaborative review of the current concepts and challenges of anastomotic leaks in colorectal surgery","volume":"19","author":"Vallance","year":"2017","journal-title":"Colorectal Dis"},{"key":"10.1016\/j.surg.2023.02.018_bib5","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.amjsurg.2010.11.014","article-title":"Incidence and risk factors for anastomotic leakage after laparoscopic anterior resection with intracorporeal rectal transection and double-stapling technique anastomosis for rectal cancer","volume":"202","author":"Akiyoshi","year":"2011","journal-title":"Am J Surg"},{"key":"10.1016\/j.surg.2023.02.018_bib6","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/S0002-9610(00)00252-X","article-title":"Risk factors for anastomotic leakage after low anterior resection with total mesorectal excision","volume":"179","author":"Law","year":"2000","journal-title":"Am J Surg"},{"key":"10.1016\/j.surg.2023.02.018_bib7","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1007\/s13304-020-00837-z","article-title":"Italian multi-society modified Delphi consensus on the definition and management of anastomotic leakage in colorectal surgery","volume":"72","author":"Spinelli","year":"2020","journal-title":"Updates Surg"},{"key":"10.1016\/j.surg.2023.02.018_bib8","doi-asserted-by":"crossref","first-page":"6172","DOI":"10.3748\/wjg.v23.i33.6172","article-title":"Definition of colorectal anastomotic leakage: a consensus survey among Dutch and Chinese colorectal surgeons","volume":"23","author":"van Rooijen","year":"2017","journal-title":"World J Gastroenterol"},{"key":"10.1016\/j.surg.2023.02.018_bib9","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/j.surg.2009.10.012","article-title":"Definition and grading of anastomotic leakage following anterior resection of the rectum: a proposal by the International Study Group of Rectal Cancer","volume":"147","author":"Rahbari","year":"2010","journal-title":"Surgery"},{"key":"10.1016\/j.surg.2023.02.018_bib10","doi-asserted-by":"crossref","first-page":"5318","DOI":"10.1007\/s00464-017-5611-0","article-title":"Influence of multiple stapler firings used for rectal division on colorectal anastomotic leak rate","volume":"31","author":"Braunschmid","year":"2017","journal-title":"Surg Endosc"},{"key":"10.1016\/j.surg.2023.02.018_bib11","doi-asserted-by":"crossref","first-page":"2972","DOI":"10.1007\/s00464-011-1655-8","article-title":"Evaluation of the learning curve in laparoscopic low anterior resection for rectal cancer","volume":"25","author":"Kayano","year":"2011","journal-title":"Surg Endosc"},{"key":"10.1016\/j.surg.2023.02.018_bib12","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1097\/SLA.0b013e31827b8ed9","article-title":"Multicenter analysis of risk factors for anastomotic leakage after laparoscopic rectal cancer excision: the Korean laparoscopic colorectal surgery study group","volume":"257","author":"Park","year":"2013","journal-title":"Ann Surg"},{"key":"10.1016\/j.surg.2023.02.018_bib13","doi-asserted-by":"crossref","first-page":"1796","DOI":"10.1007\/s00464-007-9265-1","article-title":"Experimental evaluation of the mechanical strength of stapling techniques","volume":"21","author":"Kawasaki","year":"2007","journal-title":"Surg Endosc"},{"key":"10.1016\/j.surg.2023.02.018_bib14","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1111\/codi.14631","article-title":"Integration of transanal techniques for precise rectal transection and single-stapled anastomosis: a proof-of-concept study","volume":"21","author":"Spinelli","year":"2019","journal-title":"Colorectal Disease"},{"key":"10.1016\/j.surg.2023.02.018_bib15","doi-asserted-by":"crossref","first-page":"3123","DOI":"10.1016\/j.ejso.2021.08.002","article-title":"Transanal transection and single-stapled anastomosis (TTSS): a comparison of anastomotic leak rates with the double-stapled technique and with transanal total mesorectal excision (TaTME) for rectal cancer","volume":"47","author":"Spinelli","year":"2021","journal-title":"Eur J Surg Oncol"},{"key":"10.1016\/j.surg.2023.02.018_bib16","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1007\/BF02237198","article-title":"\u201cDog ear\u201d formation after double-stapled low anterior resection as a risk factor for anastomotic disruption","volume":"43","author":"Roumen","year":"2019","journal-title":"Dis Colon Rectum"},{"key":"10.1016\/j.surg.2023.02.018_bib18","doi-asserted-by":"crossref","first-page":"3908","DOI":"10.1007\/s00464-019-07160-8","article-title":"Total mesorectal excision for low and middle rectal cancer: laparoscopic versus transanal approach-a meta-analysis","volume":"34","author":"Aubert","year":"2020","journal-title":"Surg Endosc"},{"key":"10.1016\/j.surg.2023.02.018_bib19","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/SLA.0b013e3181b13ca2","article-title":"The Clavien-Dindo classification of surgical complications: five-year experience","volume":"250","author":"Clavien","year":"2009","journal-title":"Ann Surg"},{"key":"10.1016\/j.surg.2023.02.018_bib20","doi-asserted-by":"crossref","first-page":"iv22","DOI":"10.1093\/annonc\/mdx224","article-title":"ESMO clinical practice guidelines for diagnosis, treatment and follow-up","volume":"28","author":"Glynne-Jones","year":"2017","journal-title":"Ann Oncol"},{"key":"10.1016\/j.surg.2023.02.018_bib21","doi-asserted-by":"crossref","first-page":"874","DOI":"10.6004\/jnccn.2018.0061","article-title":"Rectal cancer, version 2.2018: NCCN Clinical Practice Guidelines in Oncology","volume":"16","author":"Benson","year":"2018","journal-title":"J\u00a0Natl Compr Canc Netw"},{"key":"10.1016\/j.surg.2023.02.018_bib22","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1111\/codi.12501","article-title":"The English national low rectal cancer development programme: key messages and future perspectives","volume":"16","author":"Moran","year":"2014","journal-title":"Colorectal Dis"},{"key":"10.1016\/j.surg.2023.02.018_bib23","series-title":"AJCC Cancer Staging Manual","author":"Edge","year":"2010"},{"key":"10.1016\/j.surg.2023.02.018_bib24","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1002\/bjs.4806","article-title":"Dutch Colorectal Cancer Group. Risk factors for anastomotic failure after total mesorectal excision of rectal cancer","volume":"92","author":"Peeters","year":"2005","journal-title":"Br J Surg"},{"key":"10.1016\/j.surg.2023.02.018_bib25","first-page":"710","article-title":"An improved technique for low anterior resection of the rectum using the EEA stapler","volume":"88","author":"Knight","year":"1980","journal-title":"Surgery"},{"key":"10.1016\/j.surg.2023.02.018_bib26","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1002\/bjs.1800810852","article-title":"Novel stapling technique to facilitate low anterior resection in rectal cancer","volume":"81","author":"Moran","year":"1994","journal-title":"Br J Surg"},{"key":"10.1016\/j.surg.2023.02.018_bib27","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1016\/j.surg.2022.02.019","article-title":"Comprehensive literature review of the outcome, modifications, and alternatives to double-stapled low pelvic colorectal anastomosis","volume":"172","author":"Emile","year":"2022","journal-title":"Surgery"},{"key":"10.1016\/j.surg.2023.02.018_bib28","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1007\/s00384-008-0470-8","article-title":"Relationship between multiple numbers of stapler firings during rectal division and anastomotic leakage after laparoscopic rectal resection","volume":"23","author":"Ito","year":"2008","journal-title":"Int J Colorectal Dis"},{"key":"10.1016\/j.surg.2023.02.018_bib29","first-page":"305","article-title":"Surgical stapling device-tissue interactions: what surgeons need to know to improve patient outcomes","volume":"7","author":"Chekan","year":"2014","journal-title":"Med Devices (Auckl)"},{"key":"10.1016\/j.surg.2023.02.018_bib30","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1097\/SLE.0000000000000422","article-title":"The relationship between the number of intersections of staple lines and anastomotic leakage after the use of a double stapling technique in laparoscopic colorectal surgery","volume":"27","author":"Lee","year":"2017","journal-title":"Surg Laparosc Endosc Percutan Tech"},{"key":"10.1016\/j.surg.2023.02.018_bib31","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1016\/j.jamcollsurg.2009.09.021","article-title":"Risk factors for anastomotic leakage after laparoscopic intracorporeal colorectal anastomosis with a double stapling technique","volume":"209","author":"Kim","year":"2009","journal-title":"J\u00a0Am Coll Surg"},{"key":"10.1016\/j.surg.2023.02.018_bib32","doi-asserted-by":"crossref","first-page":"137e139","DOI":"10.1007\/s10350-004-6129-9","article-title":"Use of a mattress suture to eliminate dog ears in double-stapled and triple-stapled anastomoses","volume":"45","author":"Asao","year":"2002","journal-title":"Dis Colon Rectum"},{"key":"10.1016\/j.surg.2023.02.018_bib33","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1006\/jsre.1999.5701","article-title":"Which technique, circular stapled anastomosis or double stapling anastomosis, provides the optimal size and shape of rectal anastomotic opening?","volume":"86","author":"Sadahiro","year":"1999","journal-title":"J\u00a0Surg Res"},{"key":"10.1016\/j.surg.2023.02.018_bib34","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/s00384-012-1582-8","article-title":"Comparison of intracorporeal single-stapled and double-stapled anastomosis in laparoscopic low anterior resection for rectal cancer: a case-control study","volume":"28","author":"Kim","year":"2013","journal-title":"Int J Colorectal Dis"},{"key":"10.1016\/j.surg.2023.02.018_bib35","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1177\/1553350617709182","article-title":"Transanal inspection and management of low colorectal anastomosis performed with a new technique: the TICRANT study","volume":"24","author":"Crafa","year":"2017","journal-title":"Surg Innov"},{"key":"10.1016\/j.surg.2023.02.018_bib36","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.amjsurg.2006.12.008","article-title":"Single-stapled double-pursestring anastomosis after anterior resection of the rectum","volume":"193","author":"Marecik","year":"2007","journal-title":"Am J Surg"},{"key":"10.1016\/j.surg.2023.02.018_bib37","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1007\/s10151-016-1437-3","article-title":"Laparoscopic double-stapled colorectal anastomosis without \u201cdog-ears","volume":"20","author":"Chen","year":"2016","journal-title":"Tech Coloproctol"},{"key":"10.1016\/j.surg.2023.02.018_bib38","doi-asserted-by":"crossref","first-page":"28","DOI":"10.4240\/wjgs.v10.i3.28","article-title":"Evolution of transanal total mesorectal excision for rectal cancer: from top to bottom","volume":"10","author":"Emile","year":"2018","journal-title":"World J Gastrointest Surg"},{"key":"10.1016\/j.surg.2023.02.018_bib39","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1097\/SLA.0000000000000865","article-title":"Transanal total mesorectal excision in rectal cancer: short-term outcomes in comparison with laparoscopic surgery","volume":"261","author":"Fernandez-Hevia","year":"2015","journal-title":"Ann Surg"},{"key":"10.1016\/j.surg.2023.02.018_bib40","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1097\/SLA.0000000000002653","article-title":"Incidence and risk factors for anastomotic failure in 1594 patients treated by transanal total mesorectal excision","volume":"269","author":"Penna","year":"2019","journal-title":"Ann Surg"},{"key":"10.1016\/j.surg.2023.02.018_bib41","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/j.ejso.2020.06.037","article-title":"Surgical approach for rectal cancer: a network meta-analysis comparing open, laparoscopic, robotic and transanal TME approaches","volume":"47","author":"Ryan","year":"2021","journal-title":"Eur J Surg Oncol"},{"key":"10.1016\/j.surg.2023.02.018_bib42","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1016\/j.ejso.2020.11.131","article-title":"Comparison of transanal total mesorectal excision (TaTME) versus laparoscopic TME for rectal cancer: a case matched study","volume":"47","author":"Ye","year":"2021","journal-title":"Eur J Surg Oncol"},{"key":"10.1016\/j.surg.2023.02.018_bib43","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.asjsur.2020.05.007","article-title":"Comparison of short term efficacy of transanal total mesorectal excision and laparoscopic total mesorectal excision in low rectal cancer","volume":"44","author":"Ren","year":"2020","journal-title":"Asian J Surg"},{"key":"10.1016\/j.surg.2023.02.018_bib44","doi-asserted-by":"crossref","first-page":"2382","DOI":"10.3390\/diagnostics11122382","article-title":"Updates of risk factors for anastomotic leakage after colorectal surgery","volume":"11","author":"Zarnescu","year":"2021","journal-title":"Diagnostics (Basel)"}],"container-title":["Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0039606023000934?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0039606023000934?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T11:04:11Z","timestamp":1758539051000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0039606023000934"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6]]},"references-count":43,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["S0039606023000934"],"URL":"https:\/\/doi.org\/10.1016\/j.surg.2023.02.018","relation":{},"ISSN":["0039-6060"],"issn-type":[{"value":"0039-6060","type":"print"}],"subject":[],"published":{"date-parts":[[2023,6]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Single-stapled anastomosis is associated with a lower anastomotic leak rate than double-stapled technique after minimally invasive total mesorectal excision for MRI-defined low rectal cancer","name":"articletitle","label":"Article Title"},{"value":"Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.surg.2023.02.018","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}