{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T22:05:19Z","timestamp":1793052319528,"version":"4.5.0"},"reference-count":48,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T00:00:00Z","timestamp":1749686400000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To compare current UK surgical practice against evidence\u2010based anastomotic evaluation techniques prior to ileostomy closure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An online survey was distributed to UK consultant colorectal surgeons with Association of Coloproctology of Great Britain and Ireland affiliation to assess preoperative investigations. Data were collected at two timepoints: 2019 and 2024. A systematic review and meta\u2010analysis were performed utilising PRISMA guidelines. MEDLINE (PubMed), Embase and Education Resources Information Center databases were evaluated from inception to 27 March 2024. Inclusion criteria were adult patients (\u226518\u2009years), distal colonic\/pelvic anastomosis and defunctioning ileostomy reversal. ROBINS\u2010I bias assessments were conducted. DerSimonian and Laird random\u2010effects analyses were performed on eligible sensitivity and specificity data with forest plots generated. PROSPERO ID: CRD42024520236.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The survey received 221 (41.0%) and 212 (40.7%) responses in 2019 and 2024 respectively. Pre\u2010 and post\u2010pandemic practice was consistent. Water\u2010soluble contrast enema (WCE) and digital rectal examination (DRE) were the most utilised, performed \u2018always\u2019 by 83.2% and 78.7% respectively. Thirty\u2010seven studies (5061 patients) were included for systematic review; 12 studies (1385 patients) for meta\u2010analysis. Studies were heterogeneous in methodology; no randomised controlled trials were identified. Endoscopy showed higher sensitivity (73.1%) compared to retrograde contrast studies (WCE and pouchography; 53.1%) in identifying anastomotic leaks. Specificity was similar: 100% and 98.0% respectively. Significant heterogeneity and a lack of eligible studies limited further interpretation. CT has a limited evidence base for anastomotic evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The most commonly performed anastomotic evaluation methods in the UK are WCE and DRE. Endoscopy, however, has a greater sensitivity and specificity for identifying anastomotic complications. WCE is an effective option to confirm suspected leaks. Endoscopy should be considered to evaluate anastomotic integrity prior to ileostomy closure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.70137","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T03:21:18Z","timestamp":1749698478000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Preoperative anastomotic evaluation prior to ileostomy closure: A 5\u2010year UK survey, systematic review, and meta\u2010analysis"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5881-5275","authenticated-orcid":false,"given":"D.","family":"Atraszkiewicz","sequence":"first","affiliation":[{"name":"Broomfield Hospital Mid and South Essex NHS Foundation Trust  Chelmsford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9212-1189","authenticated-orcid":false,"given":"T.","family":"Shakir","sequence":"additional","affiliation":[{"name":"University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Harrington","sequence":"additional","affiliation":[{"name":"Whittington Hospital Whittington Health NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Bassett","sequence":"additional","affiliation":[{"name":"Statsconsultancy Ltd.  Amersham Buckinghamshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5619-8332","authenticated-orcid":false,"given":"B.","family":"Soile","sequence":"additional","affiliation":[{"name":"Whittington Hospital Whittington Health NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Mukhtar","sequence":"additional","affiliation":[{"name":"University College London  London UK"},{"name":"Whittington Hospital Whittington Health NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,12]]},"reference":[{"key":"e_1_2_13_2_1","unstructured":"Association of Coloprotoctology of Great Britain and Ireland.Ileoanal Pouch Report 2017. Available from:https:\/\/www.acpgbi.org.uk\/_userfiles\/import\/2016\/07\/Ileoanal\u2010Pouch\u2010Report\u20102017\u2010FINAL.compressed.pdf. 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