{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T13:22:33Z","timestamp":1782998553681,"version":"3.54.5"},"reference-count":36,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,7,2]],"date-time":"2023-07-02T00:00:00Z","timestamp":1688256000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81272710"],"award-info":[{"award-number":["81272710"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004826","name":"Natural Science Foundation of Beijing Municipality","doi-asserted-by":"publisher","award":["4232058"],"award-info":[{"award-number":["4232058"]}],"id":[{"id":"10.13039\/501100004826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004826","name":"Natural Science Foundation of Beijing Municipality","doi-asserted-by":"publisher","award":["L222054"],"award-info":[{"award-number":["L222054"]}],"id":[{"id":"10.13039\/501100004826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Refractory anastomotic leakage (RAL) after intersphincteric resection (ISR) usually leads to failure of protective stoma reversal in ultralow rectal cancers. The aim of this study is to assess the risk factors and oncological outcomes of both anastomotic leakage (AL) and RAL, and quality of life (QoL) of RAL after laparoscopic ISR (LsISR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 371 ultralow rectal cancer patients with LsISR were enrolled from a tertiary colorectal surgery referral center. Risk factors for AL and RAL were identified by logistic regression. Three\u2010year disease\u2010free survival (DFS) of AL and RAL was analyzed by the Cox regression. QoL of RAL group (compared with non\u2010RAL group) was assessed using the European Organization for Research and Treatment of Cancer QLQ\u2010C30 and QLQ\u2010CR29 questionnaires.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The rates of AL and RAL after LsISR accounted for 8.4% (31\/371) and 4.6% (17\/371) in this cohort, respectively. Non\u2010left colic artery preservation (odds ratio [OR]\u00a0=\u00a03.491, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.009), neoadjuvant chemoradiotherapy (nCRT) (OR\u00a0=\u00a06.038, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), and lower anastomosis height (OR\u00a0=\u00a05.271, <jats:italic>P\u00a0=<\/jats:italic>\u00a00.010) were independent risk factors for AL, while nCRT (OR\u00a0=\u00a011.602, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) was the only independent risk factor for RAL. Male (hazard ratio [HR]\u00a0=\u00a01.989, <jats:italic>P\u00a0=<\/jats:italic>\u00a00.014), age\u00a0&gt;\u00a060\u00a0years (HR\u00a0=\u00a01.877, <jats:italic>P\u00a0=<\/jats:italic>\u00a00.018), and lymph node metastasis (HR\u00a0=\u00a02.125, <jats:italic>P\u00a0=<\/jats:italic>\u00a00.005) were independent risk factors of poor 3\u2010year DFS, but not RAL (<jats:italic>P\u00a0=<\/jats:italic>\u00a00.646). RAL patients have significantly worse global health status, worse emotional and social function scores at the late postoperative stage, and worse urinary and sexual function at the early postoperative stage (all <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Neoadjuvant chemoradiotherapy was an independent risk factor for RAL after LsISR. RAL shows similar oncological outcomes, but with poor QoL.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.16270","type":"journal-article","created":{"date-parts":[[2023,7,3]],"date-time":"2023-07-03T00:43:58Z","timestamp":1688345038000},"page":"1934-1941","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Risk factors, quality of life, and oncological effects of refractory anastomotic leakage for laparoscopic intersphincteric resection"],"prefix":"10.1111","volume":"38","author":[{"given":"Junguang","family":"Liu","sequence":"first","affiliation":[{"name":"Department of General Surgery Peking University First Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of General Surgery The Second Hospital of Yulin  Yulin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hekai","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of General Surgery Tianjin Fifth Central Hospital  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiwen","family":"Mei","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenlong","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9153-6550","authenticated-orcid":false,"given":"Jianqiang","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,2]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000001155"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13194793"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-014-3573-1"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13193-016-0571-8"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-015-4461-z"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2007.01226.x"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-017-3960-4"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-018-3145-0"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.8677"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-006-0598-y"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002429"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-017-1208-2"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000568"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003889"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000001824"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2009.10.012"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v23.i10.1891"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdn417"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-021-04982-7"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-015-2340-5"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.13086"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12094"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.14728"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.14742"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.15911"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2009.07.1684"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000665"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2007.01466.x"},{"key":"e_1_2_5_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-020-03608-9"},{"key":"e_1_2_5_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-015-2289-4"},{"key":"e_1_2_5_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181deb649"},{"key":"e_1_2_5_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-021-02182-0"},{"key":"e_1_2_5_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3182128929"},{"key":"e_1_2_5_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-015-2359-7"},{"key":"e_1_2_5_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.15554"},{"key":"e_1_2_5_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.15589"}],"container-title":["Journal of Gastroenterology and Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgh.16270","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T04:35:19Z","timestamp":1744173319000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jgh.16270"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,2]]},"references-count":36,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1111\/jgh.16270"],"URL":"https:\/\/doi.org\/10.1111\/jgh.16270","archive":["Portico"],"relation":{},"ISSN":["0815-9319","1440-1746"],"issn-type":[{"value":"0815-9319","type":"print"},{"value":"1440-1746","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,2]]},"assertion":[{"value":"2022-11-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}