{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T20:14:12Z","timestamp":1790194452282,"version":"4.1.0"},"reference-count":45,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anastomotic leak (AL) after colorectal anastomosis can be a risk factor for bowel dysfunction, namely low anterior resection syndrome (LARS). The present study aimed to assess bowel dysfunction in patients who developed AL after anterior resection compared to patients without AL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a PRISMA\u2010compliant systematic review of PubMed, Scopus and Cochrane Library for randomized and observational studies investigating the association between AL after anterior resection and bowel dysfunction. The main outcomes were LARS, faecal incontinence and urgency. Pairwise meta\u2010analyses were conducted to calculate the relative risk (RR) of the study outcomes and their 95% confidence intervals (CI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      This review included 20 retrospective studies comprising 4764 patients (61.6% male, median age 63\u2009years). AL was detected in 14% of patients and those who experienced AL had a higher risk of LARS (six studies; 1329 patients, RR: 1.27 95%CI: 1.02, 1.58,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.035), major LARS (seven studies; 1395 patients, RR: 1.38, 95%CI: 1.07, 1.79,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012), urgency (five studies; 955 patients, RR: 1.15, 95%CI: 1.04, 1.27,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005) and had higher LARS scores (seven studies; 1450 patients, WMD: 6.64, 95%CI: 3.76, 9.52,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and Wexner incontinence scores (seven studies; 1045 patients, WMD: 1.72, 95%CI: 0.16, 3.28,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.031).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Based on low to moderate certainty evidence, AL after colorectal and coloanal anastomoses was significantly associated with an increased risk of LARS, particularly major LARS, urgency and higher LARS and Wexner\/Cleveland Clinic Florida\u2010Fecal Incontinence Scores.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.70186","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T08:54:28Z","timestamp":1755161668000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Association between anastomotic leak after rectal resection and bowel dysfunction, a systematic review, meta\u2010analysis and meta\u2010regression"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7854-5244","authenticated-orcid":false,"given":"Sameh Hany","family":"Emile","sequence":"first","affiliation":[{"name":"Ellen Leifer Shulman and Steven Shulman Digestive Disease Center Cleveland Clinic Florida  Weston Florida USA"},{"name":"Colorectal Surgery Unit, General Surgery Department Mansoura University Hospitals  Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta Lynn","family":"Oslin","sequence":"additional","affiliation":[{"name":"Ellen Leifer Shulman and Steven Shulman Digestive Disease Center Cleveland Clinic Florida  Weston Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjelli","family":"Wignakumar","sequence":"additional","affiliation":[{"name":"Ellen Leifer Shulman and Steven Shulman Digestive Disease Center Cleveland Clinic Florida  Weston Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nir","family":"Horesh","sequence":"additional","affiliation":[{"name":"Ellen Leifer Shulman and Steven Shulman Digestive Disease Center Cleveland Clinic Florida  Weston Florida USA"},{"name":"Department of Surgery and Transplantations, Sheba Medical Center, Ramat Gan and Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoe","family":"Garoufalia","sequence":"additional","affiliation":[{"name":"Ellen Leifer Shulman and Steven Shulman Digestive Disease Center Cleveland Clinic Florida  Weston Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8046-5753","authenticated-orcid":false,"given":"Steven D.","family":"Wexner","sequence":"additional","affiliation":[{"name":"Ellen Leifer Shulman and Steven Shulman Digestive Disease Center Cleveland Clinic Florida  Weston Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marylise","family":"Boutros","sequence":"additional","affiliation":[{"name":"Ellen Leifer Shulman and Steven Shulman Digestive Disease Center Cleveland Clinic Florida  Weston Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,14]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"American Cancer Society.Key Statistics for Colorectal Cancer. 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