{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T19:16:02Z","timestamp":1787253362937,"version":"build-2736575974"},"reference-count":35,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,7,17]],"date-time":"2019-07-17T00:00:00Z","timestamp":1563321600000},"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":["Colorectal Disease"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Management of anastomotic leakage (<jats:styled-content style=\"fixed-case\">AL<\/jats:styled-content>) following rectal resection has evolved with increasing use of less invasive techniques. The aim of this study was to review the management of <jats:styled-content style=\"fixed-case\">AL<\/jats:styled-content> following restorative rectal cancer resection in a tertiary referral centre.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A retrospective review of a prospectively maintained database was performed. The primary outcome was successful management of <jats:styled-content style=\"fixed-case\">AL<\/jats:styled-content>. The secondary outcome was the impact of <jats:styled-content style=\"fixed-case\">AL<\/jats:styled-content> on oncological outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five hundred and two restorative rectal cancer resections were performed during the study period. The incidence of <jats:styled-content style=\"fixed-case\">AL<\/jats:styled-content> was 9.9% (<jats:italic>n<\/jats:italic>\u00a0=\u00a050). <jats:styled-content style=\"fixed-case\">AL<\/jats:styled-content> occurred more commonly following neoadjuvant chemoradiotherapy (<jats:italic>n<\/jats:italic>\u00a0=\u00a031\/252, 12.3%) than in those who did not receive neoadjuvant chemoradiotherapy (<jats:italic>n<\/jats:italic>\u00a0=\u00a019\/250, 7.6%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.107); however, this was not statistically significant. Successful minimally invasive drainage was achieved in 28 patients (56%, radiological <jats:italic>n<\/jats:italic>\u00a0=\u00a024, surgical <jats:italic>n<\/jats:italic>\u00a0=\u00a04). Trans\u2010rectal drainage was the most common drainage method (<jats:italic>n<\/jats:italic>\u00a0=\u00a014). The median duration of drainage was longer in the neoadjuvant group (27 <jats:italic>vs<\/jats:italic> 18\u00a0days). Surgical intervention was required in 11 patients, with anastomotic takedown and end\u2010colostomy formation was most commonly required. Successful management of <jats:styled-content style=\"fixed-case\">AL<\/jats:styled-content> with drainage (maintenance of the anastomosis without the need for further intervention) was achieved in 26 of the 28 patients. There were no significant differences in overall or disease\u2010free survival when patients with <jats:styled-content style=\"fixed-case\">AL<\/jats:styled-content> were compared with patients without <jats:styled-content style=\"fixed-case\">AL<\/jats:styled-content> (69.4% <jats:italic>vs<\/jats:italic> 72.6%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.99 and 78.7% <jats:italic>vs<\/jats:italic> 71.3%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.45, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In selected patients, <jats:styled-content style=\"fixed-case\">AL<\/jats:styled-content> following restorative rectal resection can be effectively controlled using minimally invasive radiological or surgical drainage without the need for further intervention.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.14742","type":"journal-article","created":{"date-parts":[[2019,6,29]],"date-time":"2019-06-29T14:03:20Z","timestamp":1561817000000},"page":"1364-1371","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Minimally invasive approaches to the management of anastomotic leakage following restorative rectal cancer resection"],"prefix":"10.1111","volume":"21","author":[{"given":"B.","family":"Creavin","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery St Vincent's University Hospital Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c9. 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