{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T08:11:54Z","timestamp":1770883914377,"version":"3.50.1"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T00:00:00Z","timestamp":1720742400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T00:00:00Z","timestamp":1720742400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["No.82072732"],"award-info":[{"award-number":["No.82072732"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005089","name":"Beijing Municipal Natural Science Foundation","doi-asserted-by":"publisher","award":["L222054,4232058"],"award-info":[{"award-number":["L222054,4232058"]}],"id":[{"id":"10.13039\/501100005089","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cancer"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>In this study, we aimed to identify the risk factors in patients with rectal anastomotic re-leakage and develop a prediction model to predict the probability of rectal anastomotic re-leakage after stoma closure.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This study was a single-center retrospective analysis of patients with rectal cancer who underwent surgery between January 2010 and December 2020. Among 3225 patients who underwent Total or Partial Mesorectal Excision (TME\/PME) surgery for rectal cancer, 129 who experienced anastomotic leakage following stoma closure were enrolled. Risk factors for rectal anastomotic re-leakage were analyzed, and a prediction model was established for rectal anastomotic re-leakage.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Anastomotic re-leakage after stoma closure developed in 13.2% (17\/129) of patients. Multivariable analysis revealed that neoadjuvant chemoradiotherapy (odds ratio, 4.07; 95% confidence interval, 1.17\u201314.21; <jats:italic>p\u2009=<\/jats:italic>\u20090.03), blood loss\u2009&gt;\u200950\u00a0ml (odds ratio, 4.52; 95% confidence interval, 1.31\u201315.63; <jats:italic>p<\/jats:italic>\u2009=\u20090.02), and intersphincteric resection (intersphincteric resection vs. low anterior resection: odds ratio, 6.85; 95% confidence interval, 2.01\u201323.36; <jats:italic>p<\/jats:italic>\u2009=\u20090.002) were independent risk factors for anastomotic re-leakage. A nomogram was constructed to predict the probability of anastomotic re-leakage, with an area under the receiver operating characteristic curve of 0.828 in the cohort. Predictive results correlated with the actual results according to the calibration curve.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Neoadjuvant chemoradiotherapy, blood loss\u2009&gt;\u200950\u00a0ml, and intersphincteric resection are independent risk factors for anastomotic re-leakage following stoma closure. The nomogram can help surgeons identify patients at a higher risk of rectal anastomotic re-leakage.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12885-024-12544-8","type":"journal-article","created":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T08:02:45Z","timestamp":1720771365000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Nomogram for predicting the probability of rectal anastomotic re-leakage after stoma closure: a retrospective study"],"prefix":"10.1186","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9115-3448","authenticated-orcid":false,"given":"Yuegang","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gang","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinzhu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenlong","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiwen","family":"Mei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xishan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9153-6550","authenticated-orcid":false,"given":"Jianqiang","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,7,12]]},"reference":[{"key":"12544_CR1","first-page":"521","volume":"92","author":"N Tartaglia","year":"2021","unstructured":"Tartaglia N, Pacilli M, Pavone G, Fersini A, Lizzi V, Vovola F, et al. Functional results of surgical treatment of low-ultralow rectal cancer. Ann Ital Chir. 2021;92:521\u201330.","journal-title":"Ann Ital Chir"},{"key":"12544_CR2","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1007\/s00384-011-1357-7","volume":"27","author":"C Marquardt","year":"2012","unstructured":"Marquardt C, Koppes P, Weimann D, Schiedeck T. Laparoscopic ultralow anterior rectal resection in APPEAR technique for deep rectal cancer. Int J Colorectal Dis. 2012;27:549\u201352. https:\/\/doi.org\/10.1007\/s00384-011-1357-7","journal-title":"Int J Colorectal Dis"},{"issue":"Suppl 2","key":"12544_CR3","doi-asserted-by":"publisher","first-page":"S249","DOI":"10.1245\/s10434-015-4461-z","volume":"23","author":"M Koyama","year":"2016","unstructured":"Koyama M, Murata A, Sakamoto Y, Morohashi H, Hasebe T, Saito T, et al. Risk factors for anastomotic leakage after intersphincteric resection without a protective defunctioning stoma for lower rectal cancer. Ann Surg Oncol. 2016;23(Suppl 2):S249\u201356. https:\/\/doi.org\/10.1245\/s10434-015-4461-z","journal-title":"Ann Surg Oncol"},{"key":"12544_CR4","doi-asserted-by":"publisher","DOI":"10.3393\/ac.2022.00353.0050","author":"M Kawai","year":"2022","unstructured":"Kawai M, Sakamoto K, Honjo K, Okazawa Y, Takahashi R, Kawano S, et al. Benefits and risks of diverting stoma creation during rectal cancer surgery. Ann Coloproctol. 2022. https:\/\/doi.org\/10.3393\/ac.2022.00353.0050","journal-title":"Ann Coloproctol"},{"key":"12544_CR5","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1097\/SLA.0b013e3180603024","volume":"246","author":"P Matthiessen","year":"2007","unstructured":"Matthiessen P, Hallb\u00f6\u00f6k O, Ruteg\u00e5rd J, Simert G, Sj\u00f6dahl R. Defunctioning stoma reduces symptomatic anastomotic leakage after low anterior resection of the rectum for cancer: a randomized multicenter trial. Ann Surg. 2007;246:207\u201314. https:\/\/doi.org\/10.1097\/SLA.0b013e3180603024","journal-title":"Ann Surg"},{"key":"12544_CR6","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1111\/codi.15997","volume":"24","author":"M Degiuli","year":"2022","unstructured":"Degiuli M, Elmore U, De Luca R, De Nardi P, Tomatis M, Biondi A, et al. Risk factors for anastomotic leakage after anterior resection for rectal cancer (RALAR study): a nationwide retrospective study of the Italian Society of Surgical Oncology Colorectal Cancer Network Collaborative Group. Colorectal Dis. 2022;24:264\u201376. https:\/\/doi.org\/10.1111\/codi.15997","journal-title":"Colorectal Dis"},{"key":"12544_CR7","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1007\/s10151-020-02153-5","volume":"24","author":"A Karim","year":"2020","unstructured":"Karim A, Cubas V, Zaman S, Khan S, Patel H, Waterland P. Anastomotic leak and cancer-specific outcomes after curative rectal cancer surgery: a systematic review and meta-analysis. Tech Coloproctol. 2020;24:513\u201325. https:\/\/doi.org\/10.1007\/s10151-020-02153-5","journal-title":"Tech Coloproctol"},{"key":"12544_CR8","doi-asserted-by":"publisher","first-page":"goac058","DOI":"10.1093\/gastro\/goac058","volume":"10","author":"W Jiang","year":"2022","unstructured":"Jiang W, Wang H, Zheng J, Zhao Y, Xu S, Zhuo S, et al. Post-operative anastomotic leakage and collagen changes in patients with rectal cancer undergoing neoadjuvant chemotherapy vs chemoradiotherapy. Gastroenterol Rep (Oxf). 2022;10:goac058. https:\/\/doi.org\/10.1093\/gastro\/goac058","journal-title":"Gastroenterol Rep (Oxf)"},{"key":"12544_CR9","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1097\/DCR.0000000000000545","volume":"59","author":"F Herrle","year":"2016","unstructured":"Herrle F, Sandra-Petrescu F, Weiss C, Post S, Runkel N, Kienle P. Quality of life and timing of stoma closure in patients with rectal cancer undergoing low anterior resection with diverting stoma: a multicenter longitudinal observational study. Dis Colon Rectum. 2016;59:281\u201390. https:\/\/doi.org\/10.1097\/DCR.0000000000000545","journal-title":"Dis Colon Rectum"},{"key":"12544_CR10","doi-asserted-by":"publisher","first-page":"23","DOI":"10.3393\/ac.2015.31.1.23","volume":"31","author":"MS Walma","year":"2015","unstructured":"Walma MS, Kornmann VN, Boerma D, de Roos MA, van Westreenen HL. Predictors of fecal incontinence and related quality of life after a total mesorectal excision with primary anastomosis for patients with rectal cancer. Ann Coloproctol. 2015;31:23\u20138. https:\/\/doi.org\/10.3393\/ac.2015.31.1.23","journal-title":"Ann Coloproctol"},{"key":"12544_CR11","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1002\/jso.25488","volume":"120","author":"A Bausys","year":"2019","unstructured":"Bausys A, Kuliavas J, Dulskas A, Kryzauskas M, Pauza K, Kilius A, et al. Early versus standard closure of temporary ileostomy in patients with rectal cancer: a randomized controlled trial. J Surg Oncol. 2019;120:294\u20139. https:\/\/doi.org\/10.1002\/jso.25488","journal-title":"J Surg Oncol"},{"key":"12544_CR12","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1097\/DCR.0000000000000568","volume":"59","author":"E Hain","year":"2016","unstructured":"Hain E, Maggiori L, Manceau G, Zappa M, Prost \u00e0 la Denise J, Panis Y. Persistent asymptomatic anastomotic leakage after laparoscopic sphincter-saving surgery for rectal Cancer: can Diverting Stoma be reversed safely at 6 months? Dis Colon Rectum. 2016;59:369\u201376. https:\/\/doi.org\/10.1097\/DCR.0000000000000568","journal-title":"Dis Colon Rectum"},{"key":"12544_CR13","doi-asserted-by":"publisher","first-page":"1304","DOI":"10.1111\/codi.14728","volume":"21","author":"D Kitaguchi","year":"2019","unstructured":"Kitaguchi D, Nishizawa Y, Sasaki T, Tsukada Y, Ikeda K, Ito M. Recurrence of rectal anastomotic leakage following stoma closure: Assessment of risk factors. Colorectal Dis. 2019;21:1304\u201311. https:\/\/doi.org\/10.1111\/codi.14728","journal-title":"Colorectal Dis"},{"key":"12544_CR14","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1097\/SLA.0b013e3181b13ca2","volume":"250","author":"PA Clavien","year":"2009","unstructured":"Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009;250:187\u201396. https:\/\/doi.org\/10.1097\/SLA.0b013e3181b13ca2","journal-title":"Ann Surg"},{"key":"12544_CR15","doi-asserted-by":"publisher","first-page":"2719","DOI":"10.1200\/JCO.19.02362","volume":"38","author":"SN Lo","year":"2020","unstructured":"Lo SN, Ma J, Scolyer RA, Haydu LE, Stretch JR, Saw RPM, et al. Improved risk prediction calculator for sentinel node positivity in patients with melanoma: the melanoma institute Australia nomogram. J Clin Oncol. 2020;38:2719\u201327. https:\/\/doi.org\/10.1200\/JCO.19.02362","journal-title":"J Clin Oncol"},{"key":"12544_CR16","doi-asserted-by":"publisher","first-page":"4850","DOI":"10.3748\/wjg.v25.i33.4850","volume":"25","author":"G Feeney","year":"2019","unstructured":"Feeney G, Sehgal R, Sheehan M, Hogan A, Regan M, Joyce M, et al. Neoadjuvant radiotherapy for rectal cancer management. World J Gastroenterol. 2019;25:4850\u201369. https:\/\/doi.org\/10.3748\/wjg.v25.i33.4850","journal-title":"World J Gastroenterol"},{"key":"12544_CR17","doi-asserted-by":"publisher","first-page":"1807","DOI":"10.1007\/s00384-022-04213-8","volume":"37","author":"F Ponholzer","year":"2022","unstructured":"Ponholzer F, Klingler CP, Gasser E, Gehwolf P, Ninkovic M, Bellotti R, et al. Long-term outcome after chronic anastomotic leakage following surgery for low rectal cancer. Int J Colorectal Dis. 2022;37:1807\u201316. https:\/\/doi.org\/10.1007\/s00384-022-04213-8","journal-title":"Int J Colorectal Dis"},{"key":"12544_CR18","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1007\/s13566-016-0245-8","volume":"5","author":"I Kato","year":"2016","unstructured":"Kato I, Dyson G, Snyder M, Kim HR, Severson RK. Differential effects of patient-related factors on the outcome of radiation therapy for rectal cancer. J Radiat Oncol. 2016;5:279\u201386. https:\/\/doi.org\/10.1007\/s13566-016-0245-8","journal-title":"J Radiat Oncol"},{"key":"12544_CR19","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1097\/SLA.0000000000002429","volume":"266","author":"WAA Borstlap","year":"2017","unstructured":"Borstlap WAA, Westerduin E, Aukema TS, Bemelman WA, Tanis PJ, Dutch Snapshot Research Group. Anastomotic leakage and chronic presacral sinus formation after low anterior resection: results from a large cross-sectional study. Ann Surg. 2017;266:870\u20137. https:\/\/doi.org\/10.1097\/SLA.0000000000002429","journal-title":"Ann Surg"},{"key":"12544_CR20","doi-asserted-by":"publisher","first-page":"O135","DOI":"10.1111\/codi.13300","volume":"18","author":"SB Lim","year":"2016","unstructured":"Lim SB, Yu CS, Kim CW, Yoon YS, Park IJ, Kim JC. Late anastomotic leakage after low anterior resection in rectal cancer patients: clinical characteristics and predisposing factors. Colorectal Dis. 2016;18:O135\u201340. https:\/\/doi.org\/10.1111\/codi.13300","journal-title":"Colorectal Dis"},{"key":"12544_CR21","doi-asserted-by":"publisher","first-page":"934","DOI":"10.1097\/DCR.0000000000000665","volume":"59","author":"Q Qin","year":"2016","unstructured":"Qin Q, Ma T, Deng Y, Zheng J, Zhou Z, Wang H, et al. Impact of preoperative radiotherapy on anastomotic leakage and stenosis after rectal cancer resection: Post hoc analysis of a randomized controlled trial. Dis Colon Rectum. 2016;59:934\u201342. https:\/\/doi.org\/10.1097\/DCR.0000000000000665","journal-title":"Dis Colon Rectum"},{"key":"12544_CR22","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1016\/s0039-6109(05)70568-5","volume":"77","author":"FJ Thornton","year":"1997","unstructured":"Thornton FJ, Barbul A. Healing in the gastrointestinal tract. Surg Clin North Am. 1997;77:549\u201373. https:\/\/doi.org\/10.1016\/s0039-6109(05)70568-5","journal-title":"Surg Clin North Am"},{"key":"12544_CR23","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1007\/s13304-016-0351-6","volume":"68","author":"D Scala","year":"2016","unstructured":"Scala D, Niglio A, Pace U, Ruffolo F, Rega D, Delrio P. Laparoscopic intersphincteric resection: indications and results. Updates Surg. 2016;68:85\u201391. https:\/\/doi.org\/10.1007\/s13304-016-0351-6","journal-title":"Updates Surg"},{"key":"12544_CR24","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1097\/SLA.0b013e3181deb649","volume":"251","author":"AS Allison","year":"2010","unstructured":"Allison AS, Bloor C, Faux W, Arumugam P, Widdison A, Lloyd-Davies E, et al. The angiographic anatomy of the small arteries and their collaterals in colorectal resections: some insights into anastomotic perfusion. Ann Surg. 2010;251:1092\u20137. https:\/\/doi.org\/10.1097\/SLA.0b013e3181deb649","journal-title":"Ann Surg"},{"key":"12544_CR25","doi-asserted-by":"publisher","first-page":"1099","DOI":"10.1007\/s10151-023-02808","volume":"27","author":"K Talboom","year":"2023","unstructured":"Talboom K, Greijdanus NG, Brinkman N, Blok RD, Roodbeen SX. Comparison of proactive and conventional treatment of anastomotic leakage in rectal cancer surgery: a multicentre retrospective cohort series. Tech Coloproctol. 2023;27:1099\u2013108. https:\/\/doi.org\/10.1007\/s10151-023-02808","journal-title":"Tech Coloproctol"}],"container-title":["BMC Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12885-024-12544-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12885-024-12544-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12885-024-12544-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T08:05:43Z","timestamp":1720771543000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmccancer.biomedcentral.com\/articles\/10.1186\/s12885-024-12544-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,12]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["12544"],"URL":"https:\/\/doi.org\/10.1186\/s12885-024-12544-8","relation":{},"ISSN":["1471-2407"],"issn-type":[{"value":"1471-2407","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,12]]},"assertion":[{"value":"18 April 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 June 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 July 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Ethics Committee of Cancer Hospital, Chinese Academy of Medical Sciences (ethical approval number 22\/503\u20133705). All patients provided written informed consent.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not Applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"834"}}