{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T23:54:33Z","timestamp":1767830073825,"version":"3.49.0"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,12,26]],"date-time":"2020-12-26T00:00:00Z","timestamp":1608940800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004374","name":"Medtronic","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004374","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Anastomotic leakage is a severe complication after low anterior resection (LAR) for rectal cancer and occurs in up to 20% of patients. Most research focuses on reducing its incidence and finding predictive factors for anastomotic leakage. There are no robust data on severity and treatment strategies with associated outcomes. The aims of this work were (1) to investigate the factors that contribute to severity of anastomotic leakage and to compose an anastomotic leakage severity score and (2) to evaluate the effects of different treatment approaches on prespecified outcome parameters, stratified for severity score and other leakage characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>TENTACLE\u2013Rectum is an international multicentre retrospective cohort study. Patients with anastomotic leakage after LAR for primary rectal cancer between 1 January 2014 and 31 December 2018 will be included by each centre. We aim to include 1246 patients in this study. The primary outcome is 1\u2010year stoma\u2010free survival (i.e. patients alive at 1\u00a0year without a stoma). Secondary outcomes include number of reinterventions and unplanned readmissions within 1\u00a0year, total length of hospital stay, total time with a stoma, the type of stoma present at 1\u00a0year (defunctioning, permanent), complications related to secondary leakage and mortality. For aim (1) regression models will be used to create an anastomotic leakage severity score. For aim (2) the effectiveness of different treatment strategies for leakage will be tested after correction for severity score and leakage characteristics, in addition to other potential related confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>TENTACLE\u2013Rectum will be an important step towards drawing up evidence\u2010based recommendations and improving outcomes for patients who experience severe treatment\u2010related morbidity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.15435","type":"journal-article","created":{"date-parts":[[2020,11,10]],"date-time":"2020-11-10T10:22:03Z","timestamp":1605003723000},"page":"982-988","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Treatment of anastomotic leakage after rectal cancer resection: The TENTACLE\u2013Rectum study"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0623-9066","authenticated-orcid":false,"given":"Frans","family":"van Workum","sequence":"first","affiliation":[{"name":"Department of Surgery Radboud University Medical Center Nijmegen The Netherlands"},{"name":"Department of Surgery and cancer Imperial College London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Talboom","sequence":"additional","affiliation":[{"name":"Department of Surgery Amsterdam University Medical Centers University of Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerjon","family":"Hannink","sequence":"additional","affiliation":[{"name":"Department of Operating Rooms Radboud University Medical Center Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1200-387X","authenticated-orcid":false,"given":"Albert","family":"Wolthuis","sequence":"additional","affiliation":[{"name":"Department of Surgery UZ Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Borja F.","family":"de Lacy","sequence":"additional","affiliation":[{"name":"Department of Surgery Hospital Clinic de Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremie H.","family":"Lefevre","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery Sorbonne Universit\u00e9, AP\u2010HP H\u00f4pital Saint Antoine Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5602-6045","authenticated-orcid":false,"given":"Michael","family":"Solomon","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Sydney Central Clinical School Camperdown New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4753-1832","authenticated-orcid":false,"given":"Matteo","family":"Frasson","sequence":"additional","affiliation":[{"name":"Department of Surgery Valencia University Hospital La Fe Valencia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4811-3739","authenticated-orcid":false,"given":"Nicolas","family":"Rotholtz","sequence":"additional","affiliation":[{"name":"Department of Surgery Hospital Alem\u00e1n Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3088-5244","authenticated-orcid":false,"given":"Quentin","family":"Denost","sequence":"additional","affiliation":[{"name":"Department of Surgery Bordeaux University Hospital Bordeaux France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodrigo Oliva","family":"Perez","sequence":"additional","affiliation":[{"name":"Colorectal Surgery Hospital Alem\u00e3o Oswaldo Cruz S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsuyoshi","family":"Konishi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yves","family":"Panis","sequence":"additional","affiliation":[{"name":"Colorectal Department Beaujon Hospital, Clichy, and University of Paris Clichy France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camiel","family":"Rosman","sequence":"additional","affiliation":[{"name":"Department of Surgery Radboud University Medical Center Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roel","family":"Hompes","sequence":"additional","affiliation":[{"name":"Department of Surgery Amsterdam University Medical Centers University of Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3146-3310","authenticated-orcid":false,"given":"Pieter J.","family":"Tanis","sequence":"additional","affiliation":[{"name":"Department of Surgery Amsterdam University Medical Centers University of Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes H. W.","family":"de Wilt","sequence":"additional","affiliation":[{"name":"Department of Surgery Radboud University Medical Center Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,12,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002429"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002653"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10332"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-015-1050-3"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-014-4187-3"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-007-0399-3"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.4240\/wjgs.v7.i12.378"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000822"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.14742"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003251"},{"issue":"6","key":"e_1_2_8_13_1","first-page":"385","article-title":"Proposed definitions for the audit of postoperative infection: a discussion paper. Surgical Infection Study Group","volume":"73","author":"Peel AL","year":"1991","journal-title":"Ann R Coll Surg Engl"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e318296c732"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0962280207081236"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-015-4117-x"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2016.09.098"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v24.i21.2247"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-016-3255-3"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2008.01585.x"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2010.02245.x"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12094"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.15435","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/codi.15435","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.15435","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,2]],"date-time":"2023-09-02T03:32:13Z","timestamp":1693625533000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.15435"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,26]]},"references-count":21,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,4]]}},"alternative-id":["10.1111\/codi.15435"],"URL":"https:\/\/doi.org\/10.1111\/codi.15435","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,26]]},"assertion":[{"value":"2020-09-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}