{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T06:22:52Z","timestamp":1776493372019,"version":"3.51.2"},"reference-count":48,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T00:00:00Z","timestamp":1685577600000},"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":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Anastomotic leakage (AL) as a result of creation of a colorectal\/anal anastomosis still represents a frequent complication of colorectal surgery, with short\u2010 and long\u2010term consequences on postoperative morbidity, quality of life and oncological outcomes. However, early diagnosis of AL may result in improved outcomes. The aims of this study were to evaluate the diagnostic accuracy of water\u2010soluble contrast enema (WSCE), contrast enema computed tomography (CECT) and endoscopy in identifying AL and to identify the diagnostic procedure that is most accurate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review and meta\u2010analysis of 19 studies accounting for a total of 25 tests reporting diagnostic accuracy estimates was conducted following the Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses of Diagnostic Test Accuracy Studies (PRISMA\u2010DTA) guidelines up to June 2021. For the diagnostic tests we evaluated the pooled estimates and conducted pairwise comparisons.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>For WSCE, the pooled sensitivity was 0.50, the pooled specificity was 0.99 and the area under the curve (AUC) was 0.91. For endoscopy, the pooled sensitivity was 0.69, specificity was 1.00 and AUC was 0.99. The pooled sensitivity and specificity for CECT were 0.89 and 1.00, respectively; the AUC was 0.99. The comparison between CECT and WSCE highlighted a significantly greater sensitivity (<jats:italic>p<\/jats:italic>\u2009=\u20090.04) for CECT, whereas no difference was found for specificity. Compared with CECT, endoscopy was not significantly more accurate in terms of either sensitivity or specificity. Endoscopy was found to be significantly more specific than WSCE (<jats:italic>p<\/jats:italic>\u2009=\u20090.031) but no difference was found for sensitivity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Water\u2010soluble contrast enema, endoscopy and CECT have an elevated diagnostic accuracy. However, WSCE is less accurate than either endoscopy or CECT. Although greater sensitivity was demonstrated for CECT compared with endoscopy, this was not significant.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.16591","type":"journal-article","created":{"date-parts":[[2023,6,2]],"date-time":"2023-06-02T11:52:06Z","timestamp":1685706726000},"page":"1371-1380","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Diagnostic accuracy of water\u2010soluble contrast enema, contrast\u2010enema computed tomography and endoscopy in detecting anastomotic leakage after (Colo) proctectomy: A meta\u2010analysis"],"prefix":"10.1111","volume":"25","author":[{"given":"Andrea","family":"Chierici","sequence":"first","affiliation":[{"name":"Service de Chirurgie Digestive et Transplantation H\u00e9patique \u2010 H\u00f4pital l\u2019Archet 2, Centre Hospitalier Universitaire de Nice  Nice France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9167-3400","authenticated-orcid":false,"given":"Stefano","family":"Granieri","sequence":"additional","affiliation":[{"name":"General Surgery Unit, ASST\u2010Brianza, Vimercate Hospital, Via Santi Cosma e Damiano  Vimercate Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7434-1797","authenticated-orcid":false,"given":"Alice","family":"Frontali","sequence":"additional","affiliation":[{"name":"Coloproctology and IBD Surgery Unit, IRCCS San Raffaele  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,6]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2009.10.012"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13304\u2010020\u201000837\u2010z"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v26.i23.3293"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002429"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9697"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000568"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151\u2010021\u201002468\u2010x"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.16069"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2016.09.037"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10332"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2014.11.002"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000554"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384\u2010016\u20102744\u2010x"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.19163"},{"key":"e_1_2_12_16_1","volume-title":"Cochrane handbook for systematic reviews of diagnostic test accuracy version 1.0.0. 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