{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:47:21Z","timestamp":1787014041692,"version":"build-2736575974"},"reference-count":15,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T00:00:00Z","timestamp":1702252800000},"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":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Surgeons often have strong opinions about how to perform colorectal anastomoses with little data to support variations in technique. The aim of this study was to determine if location of the end\u2010to\u2010end (EEA) stapler spike relative to the rectal transection line is associated with anastomotic integrity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This study was a retrospective analysis of a quality collaborative database at a quaternary centre and regional hospitals. Patients with any left\u2010sided colon resection with double\u2010stapled anastomosis were included (December 2019 to August 2022). Our primary endpoint was a composite outcome including positive air insufflation test, incomplete anastomotic donut, or thin\/eccentric donut. Our secondary endpoint was clinical leak.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 633 patients were included and stratified by location of the stapler spike relative to the rectal transection line. Of note, 86 patients had an end\u2010colon to anterior rectum (\u201creverse Baker\u201d) anastomosis with no crossing staple lines. The rates of the composite endpoint based on position of the stapler spike were 12.4% (anterior), 8.1% (through), 12.8% (posterior), 5.1% (corner), and 2.3% for the \u201creverse Baker\u201d (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03). The overall rate of clinical leak was 3.8% and there were no differences between methods. In a multivariate analysis, the \u201creverse Baker\u201d anastomosis was associated with decreased odds of poor anastomotic integrity when compared to anastomoses with crossing staple lines (OR 0.20, 95% CI: 0.05\u20130.87,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>For anastomoses with crossing staple lines, the position of the stapler spike relative to the rectal staple line is not associated with differences in anastomotic integrity. In contrast, anastomoses with no crossing staple lines resulted in significantly lower rates of poor anastomotic integrity, but no difference in clinical leaks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.16833","type":"journal-article","created":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T16:00:50Z","timestamp":1702396850000},"page":"137-144","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Fact or fiction? Does the position of the end\u2010to\u2010end (\n                    <scp>EEA<\/scp>\n                    ) stapler spike matter for colorectal anastomoses using a double\u2010stapled technique?"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3594-5453","authenticated-orcid":false,"given":"Paul","family":"Cavallaro","sequence":"first","affiliation":[{"name":"Department of Colon and Rectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace C.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Colon and Rectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arielle","family":"Kanters","sequence":"additional","affiliation":[{"name":"Department of Colon and Rectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Valente","sequence":"additional","affiliation":[{"name":"Department of Colon and Rectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2549-9042","authenticated-orcid":false,"given":"Stefan D.","family":"Holubar","sequence":"additional","affiliation":[{"name":"Department of Colon and Rectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley","family":"Champagne","sequence":"additional","affiliation":[{"name":"Department of Colon and Rectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Rosen","sequence":"additional","affiliation":[{"name":"Department of Colon and Rectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emre","family":"Gorgun","sequence":"additional","affiliation":[{"name":"Department of Colon and Rectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Steele","sequence":"additional","affiliation":[{"name":"Department of Colon and Rectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,11]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/S00464\u2010007\u20109265\u20101"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/S00384\u2010022\u201004197\u20105"},{"key":"e_1_2_11_4_1","volume-title":"UPDATE: Safe Use of Surgical Staplers and Staples\u2014Letter to Health Care Providers","author":"U.S. Food and Drug 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of the rectum using the EEA stapler","volume":"88","author":"Knight CD","year":"1980","journal-title":"Surgery"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/2013.JAMASURG.33"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/S00464\u2010017\u20105611\u20100"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.16833","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,27]],"date-time":"2024-01-27T01:43:48Z","timestamp":1706319828000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.16833"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,11]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1111\/codi.16833"],"URL":"https:\/\/doi.org\/10.1111\/codi.16833","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,11]]},"assertion":[{"value":"2023-07-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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