{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T03:59:50Z","timestamp":1754020790681,"version":"3.40.5"},"reference-count":17,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,12,9]],"date-time":"2020-12-09T00:00:00Z","timestamp":1607472000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Currently no consensus exists regarding what pre\u2010reversal investigations are required to assess integrity of the rectal anastomosis. The objective of this study was to compare pre\u2010reversal assessments of anastomotic integrity and to evaluate trends that might have influenced timings for reversal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From a prospectively maintained database, patients with colorectal cancer resections between March 2012 and October 2019 were identified. Patient characteristics, pre\u2010reversal contrast enema and flexible sigmoidoscopy findings were recorded, and management of complications were recorded. Time\u2010to\u2010ileostomy reversal and time series for trends were analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 154 patients included. Pre\u2010reversal contrast enema or sigmoidoscopy detected a possible stricture or leak at the rectal anastomotic site in 11% (15\/132) and 15% (18\/112), respectively. When both modalities were used there was concordance of 86.1% and a positive likelihood ratio of 5.73. Of 125 (81.2%) ileostomies reversed, the median time\u2010to\u2010reversal was 11.99\u2009months; time series analysis over the 7\u2010year period showed no significant trend for average patient\u2010days from booking to reversal (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.60). Cox regression modelling did not identify any influential risk factors for the times taken to reversal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study supports the use of both contrast enema and flexible sigmoidoscopy in the assessment of rectal anastomosis integrity. Most patients with complications can have their ileostomies reversed. Patients who have adjuvant chemotherapy have a prolonged time to reversal.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.16483","type":"journal-article","created":{"date-parts":[[2020,12,10]],"date-time":"2020-12-10T22:16:19Z","timestamp":1607638579000},"page":"938-942","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Investigations and time trends in loop ileostomy reversals following anterior resections: a single Australian institution seven\u2010years' experience"],"prefix":"10.1111","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6035-639X","authenticated-orcid":false,"given":"Danielle","family":"Taylor","sequence":"first","affiliation":[{"name":"Department of Surgery Western Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9134-7509","authenticated-orcid":false,"given":"Alex","family":"Besson","sequence":"additional","affiliation":[{"name":"Department of Surgery Western Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian G.","family":"Faragher","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Western Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven T. F.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Surgery Western Health  Melbourne Victoria Australia"},{"name":"Department of Surgery, Western Precinct The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin M.","family":"Yeung","sequence":"additional","affiliation":[{"name":"Department of Surgery Western Health  Melbourne Victoria Australia"},{"name":"Department of Colorectal Surgery Western Health  Melbourne Victoria Australia"},{"name":"Department of Surgery, Western Precinct The University of Melbourne  Melbourne Victoria Australia"},{"name":"Western Health Chronic Disease Alliance Western Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,12,9]]},"reference":[{"volume-title":"Colorectal and Other Digestive\u2010Tract Cancers. Cancer Series No.114","year":"2018","author":"Australian Institute of Health and Welfare","key":"e_1_2_9_2_1"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000375324"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-015-2225-7"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-016-0885-6"},{"key":"e_1_2_9_6_1","first-page":"417","article-title":"Is water\u2010soluble contrast enema examination for integrity of rectal anastomosis necessary prior to ileostomy reversal?","volume":"4","author":"Goh HL","year":"2020","journal-title":"J. Gastroenterol. 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