{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T03:51:33Z","timestamp":1793505093695,"version":"4.5.0"},"reference-count":47,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"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":[[2026,12]]},"DOI":"10.1016\/j.surg.2026.110558","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:57:06Z","timestamp":1787759826000},"page":"110558","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"special_numbering":"C","title":["Single-stapled versus double-stapled colorectal anastomosis after anterior resection: Systematic review and meta-analysis of short-term and functional outcomes"],"prefix":"10.1016","volume":"200","author":[{"given":"Antonio","family":"Luberto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4743-7181","authenticated-orcid":false,"given":"Fabio","family":"Carbone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Rega","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Di Marzo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Foppa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonino","family":"Spinelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Delrio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.surg.2026.110558_bib1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ejso.2023.107069","article-title":"Tumour-specific mesorectal excision for rectal cancer: systematic review and meta-analysis of oncological and functional outcomes","volume":"49","author":"Carbone","year":"2023","journal-title":"Eur J Surg Oncol"},{"key":"10.1016\/j.surg.2026.110558_bib2","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1177\/014107688808100904","article-title":"The 'Holy Plane' of rectal surgery","volume":"81","author":"Heald","year":"1988","journal-title":"J R Soc Med"},{"key":"10.1016\/j.surg.2026.110558_bib3","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1016\/S1470-2045(08)70129-3","article-title":"Controversies of total mesorectal excision for rectal cancer in elderly patients","volume":"9","author":"Rutten","year":"2008","journal-title":"Lancet Oncol"},{"key":"10.1016\/j.surg.2026.110558_bib4","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1007\/s00384-024-04596-w","article-title":"Clinical outcomes and perioperative morbidity and mortality following segmental resections of the Colon for Crohn\u2019s colitis","volume":"39","author":"Kappenberger","year":"2024","journal-title":"Int J Colorectal Dis"},{"key":"10.1016\/j.surg.2026.110558_bib5","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.3390\/jcm15031040","article-title":"Comprehensive approaches to endometriosis management and targeted strategies for bowel endometriosis","volume":"15","author":"Fruscalzo","year":"2026","journal-title":"J Clin Med"},{"key":"10.1016\/j.surg.2026.110558_bib6","first-page":"46","article-title":"Is there an indication for surgical resection in Colorectal Adenoma?","volume":"30","author":"R\u00fcth","year":"2014","journal-title":"Viszeralmedizin"},{"key":"10.1016\/j.surg.2026.110558_bib7","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.2026.110558_bib8","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1001\/2013.jamasurg.2","article-title":"Risk factors for anastomotic leakage after anterior resection for rectal cancer","volume":"148","author":"Kang","year":"2013","journal-title":"JAMA Surg"},{"key":"10.1016\/j.surg.2026.110558_bib9","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.amjsurg.2010.11.014","article-title":"Incidence of 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.2026.110558_bib10","doi-asserted-by":"crossref","first-page":"13321","DOI":"10.12998\/wjcc.v10.i36.13321","article-title":"Anastomotic leakage in rectal cancer surgery: retrospective analysis of risk factors","volume":"10","author":"Brisinda","year":"2022","journal-title":"World J Clin Cases"},{"key":"10.1016\/j.surg.2026.110558_bib11","doi-asserted-by":"crossref","DOI":"10.1097\/SLA.0000000000003889","article-title":"Oncological outcomes after anastomotic leakage after surgery for Colon or rectal cancer: increased risk of local recurrence","volume":"275","author":"Koedam","year":"2022","journal-title":"Ann Surg"},{"key":"10.1016\/j.surg.2026.110558_bib12","article-title":"Low rectal cancer anastomosis: techniques, indications and functional outcomes","volume":"103","author":"G\u00e1lvez","year":"2025","journal-title":"Cirugia Espanola"},{"key":"10.1016\/j.surg.2026.110558_bib13","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 Dis"},{"key":"10.1016\/j.surg.2026.110558_bib14","doi-asserted-by":"crossref","first-page":"361","DOI":"10.3393\/ac.2025.00472.0067","article-title":"Achieving the perfect end-to-end single-stapled anastomosis in low anterior resection for rectal cancer: technical aspects","volume":"41","author":"Fu","year":"2025","journal-title":"Ann Coloproctol"},{"key":"10.1016\/j.surg.2026.110558_bib15","article-title":"Double-stapled anastomosis without \u201cdog-ears\u201d reduces the anastomotic leakage in laparoscopic anterior resection of rectal cancer: a prospective, randomized, controlled study","volume":"9","author":"Yang","year":"2022","journal-title":"Front Surg"},{"key":"10.1016\/j.surg.2026.110558_bib17","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijsu.2021.105906","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"88","author":"Page","year":"2021","journal-title":"Int J Surg"},{"key":"10.1016\/j.surg.2026.110558_bib18","series-title":"Single-Stapled Versus Double-Stapled Colorectal Anastomosis After Anterior Resection: Meta-Analysis of Short-Term And Functional Outcomes","author":"Carbone","year":"2026"},{"key":"10.1016\/j.surg.2026.110558_bib19","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1097\/SLA.0b013e31828fac0b","article-title":"International validation of the low anterior resection syndrome score","volume":"259","author":"Juul","year":"2014","journal-title":"Ann Surg"},{"key":"10.1016\/j.surg.2026.110558_bib20","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1097\/01.sla.0000133083.54934.ae","article-title":"Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey","volume":"240","author":"Dindo","year":"2004","journal-title":"Ann Surg"},{"key":"10.1016\/j.surg.2026.110558_bib21","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"10.1016\/j.surg.2026.110558_bib22","article-title":"ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"Sterne","year":"2016","journal-title":"BMJ"},{"key":"10.1016\/j.surg.2026.110558_bib23","doi-asserted-by":"crossref","first-page":"4","DOI":"10.3390\/publications14010004","article-title":"The Newcastle\u2013Ottawa scale for assessing the quality of studies in systematic reviews","volume":"14","author":"Gualdi-Russo","year":"2026","journal-title":"Publications"},{"key":"10.1016\/j.surg.2026.110558_bib24","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1136\/bmj.39489.470347.AD","article-title":"GRADE: an emerging consensus on rating quality of evidence and strength of recommendations","volume":"336","author":"Guyatt","year":"2008","journal-title":"BMJ"},{"key":"10.1016\/j.surg.2026.110558_bib25","first-page":"719","article-title":"Statistical aspects of the analysis of data from retrospective studies of disease","volume":"22","author":"Mantel","year":"1959","journal-title":"J Natl Cancer Inst"},{"key":"10.1016\/j.surg.2026.110558_bib26","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1002\/sim.1186","article-title":"Quantifying heterogeneity in a meta-analysis","volume":"21","author":"Higgins","year":"2002","journal-title":"Stat Med"},{"key":"10.1016\/j.surg.2026.110558_bib27","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta-analysis detected by a simple, graphical test","volume":"315","author":"Egger","year":"1997","journal-title":"BMJ"},{"key":"10.1016\/j.surg.2026.110558_bib28","doi-asserted-by":"crossref","first-page":"1935","DOI":"10.1245\/s10434-025-18742-3","article-title":"Robotic intracorporeal single-stapled anastomosis (RISS) is associated with lower anastomotic leakage rates than the double-stapled technique after minimally invasive total mesorectal excision for rectal cancer","volume":"33","author":"Stevanato Filho","year":"2026","journal-title":"Ann Surg Oncol"},{"key":"10.1016\/j.surg.2026.110558_bib29","doi-asserted-by":"crossref","DOI":"10.1016\/j.ejso.2025.109759","article-title":"Long-term functional outcomes after Transanal Transection and Single-Stapled (TTSS) anastomosis for rectal cancer measured by ELECTRONIC Patients Reported Outcome Measures (ePROMs)","volume":"51","author":"Foppa","year":"2025","journal-title":"Eur J Surg Oncol"},{"key":"10.1016\/j.surg.2026.110558_bib30","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1111\/ans.19387","article-title":"Single versus double stapled anastomosis in natural orifice specimen extraction (NOSE) laparoscopic anterior resection","volume":"95","author":"Raju","year":"2025","journal-title":"ANZ J Surg"},{"key":"10.1016\/j.surg.2026.110558_bib31","doi-asserted-by":"crossref","first-page":"2346","DOI":"10.1111\/codi.16789","article-title":"IDEAL stage 2a\/b prospective cohort study of transanal transection and single-stapled anastomosis for rectal cancer","volume":"25","author":"Harji","year":"2023","journal-title":"Colorectal Dis"},{"key":"10.1016\/j.surg.2026.110558_bib32","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1016\/j.surg.2023.02.018","article-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","volume":"173","author":"Foppa","year":"2023","journal-title":"Surgery"},{"key":"10.1016\/j.surg.2026.110558_bib33","doi-asserted-by":"crossref","first-page":"1601","DOI":"10.1007\/s00384-022-04197-5","article-title":"The use of single-stapling techniques reduces anastomotic complications in minimal-invasive rectal surgery","volume":"37","author":"Brunner","year":"2022","journal-title":"Int J Colorectal Dis"},{"key":"10.1016\/j.surg.2026.110558_bib34","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.2026.110558_bib35","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1097\/DCR.0000000000000739","article-title":"Natural orifice specimen extraction with single stapling colorectal anastomosis for laparoscopic anterior resection: feasibility, outcomes, and technical considerations","volume":"60","author":"Saurabh","year":"2017","journal-title":"Dis Colon Rectum"},{"key":"10.1016\/j.surg.2026.110558_bib36","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1007\/s00595-013-0646-x","article-title":"Single versus double stapling anastomotic technique in rectal cancer surgery","volume":"44","author":"Radovanovic","year":"2014","journal-title":"Surg Today"},{"key":"10.1016\/j.surg.2026.110558_bib37","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\u2013control study","volume":"28","author":"Kim","year":"2013","journal-title":"Int J Colorectal Dis"},{"key":"10.1016\/j.surg.2026.110558_bib38","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/1477-7819-5-35","article-title":"Outcomes of resection for rectal cancer in India: the impact of the double stapling technique","volume":"5","author":"Shrikhande","year":"2007","journal-title":"World J Surg Oncol"},{"key":"10.1016\/j.surg.2026.110558_bib39","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1111\/j.1445-2197.1996.tb00757.x","article-title":"Morbidity and mortality after single- and double-stapled colorectal anastomoses in patients with carcinoma of the rectum","volume":"66","author":"Moore","year":"1996","journal-title":"Aust N Z J Surg"},{"key":"10.1016\/j.surg.2026.110558_bib40","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1007\/BF02081404","article-title":"Early detection of anastomotic leaks after low anterior resection of the rectum","volume":"39","author":"Miller","year":"1996","journal-title":"Dis Colon Rectum"},{"key":"10.1016\/j.surg.2026.110558_bib41","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1007\/BF02049936","article-title":"Single vs. double stapling technique in colorectal surgery: a prospective randomized trial","volume":"34","author":"Moritz","year":"1991","journal-title":"Dis Colon Rectum"},{"key":"10.1016\/j.surg.2026.110558_bib42","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1097\/DCR.0000000000003478","article-title":"Impact of anastomotic leakage after colorectal cancer surgery on quality of life: a systematic review","volume":"68","author":"Gielen","year":"2025","journal-title":"Dis Colon Rectum"},{"key":"10.1016\/j.surg.2026.110558_bib43","doi-asserted-by":"crossref","first-page":"8336","DOI":"10.1097\/JS9.0000000000004235","article-title":"Differential impact of anastomotic leak on long-term recurrence after surgery for rectal versus colonic cancer: a systematic review and meta-analysis","volume":"112","author":"Yang","year":"2025","journal-title":"Int J Surg"},{"key":"10.1016\/j.surg.2026.110558_bib44","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.1097\/DCR.0000000000003382","article-title":"Association between cross-stapling technique in mechanical colorectal anastomosis and short-term outcomes","volume":"67","author":"Guerra","year":"2024","journal-title":"Dis Colon Rectum"},{"key":"10.1016\/j.surg.2026.110558_bib46","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.2026.110558_bib47","doi-asserted-by":"crossref","DOI":"10.1093\/bjsopen\/zrag078","article-title":"Single-stapling versus double-stapling technique for rectal anastomosis-meta-analysis","volume":"10","author":"Kehagias","year":"2026","journal-title":"BJS Open"},{"key":"10.1016\/j.surg.2026.110558_bib48","doi-asserted-by":"crossref","first-page":"1996","DOI":"10.1111\/codi.17184","article-title":"Technical risk factors for benign anastomotic strictures in colorectal and\/or coloanal anastomosis: a retrospective case-control study","volume":"26","author":"Garoufalia","year":"2024","journal-title":"Colorectal Dis"},{"key":"10.1016\/j.surg.2026.110558_bib49","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1002\/bjs.9697","article-title":"Systematic review of preoperative, intraoperative and postoperative risk factors for colorectal anastomotic leaks","volume":"102","author":"McDermott","year":"2015","journal-title":"Br J Surg"}],"container-title":["Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0039606026004836?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0039606026004836?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T09:28:53Z","timestamp":1789723733000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0039606026004836"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,12]]},"references-count":47,"alternative-id":["S0039606026004836"],"URL":"https:\/\/doi.org\/10.1016\/j.surg.2026.110558","relation":{},"ISSN":["0039-6060"],"issn-type":[{"value":"0039-6060","type":"print"}],"subject":[],"published":{"date-parts":[[2026,12]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Single-stapled versus double-stapled colorectal anastomosis after anterior resection: Systematic review and meta-analysis of short-term and functional outcomes","name":"articletitle","label":"Article Title"},{"value":"Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.surg.2026.110558","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"110558"}}