• adhesive hydrogel
• anastomotic leakage
• antibacterial
• antioxidant
• postoperative adhesion

• Animals
• Anti-Bacterial Agents/pharmacology
• Anti-Bacterial Agents/chemistry
• Hydrogels/chemistry
• Hydrogels/pharmacology
• Rabbits
• Tissue Adhesives/pharmacology
• Tissue Adhesives/chemistry
• Rats
• Antioxidants/pharmacology
• Antioxidants/chemistry
• Tissue Adhesions/prevention & control
• Anastomotic Leak/prevention & control
• Anastomotic Leak/drug therapy
• Rats, Sprague-Dawley
• Male
• Hyaluronic Acid/chemistry
• Tannins/chemistry
• Colon/surgery
• Wound Healing/drug effects
• Polylysine/chemistry

• 52425312 National Natural Science Foundation of China
• 22105198 National Natural Science Foundation of China
• 52173147 National Natural Science Foundation of China
• 52473157 National Natural Science Foundation of China
• 2022YYGFZJC018 First Hospital of Jilin University and Changchun Institute of Applied Chemistry, CAS, Joint Laboratory of Medicine and Polymers Project

• Artificial intelligence
• Machine learning
• Prediction model
• Preoperative prediction
• Risk factors

• Humans
• Anastomotic Leak/diagnosis
• Anastomotic Leak/etiology
• Risk Factors
• Viscera/surgery

• Anastomotic leakage
• Anastomotic wound healing
• Poly-epsilon-caprolactone
• Rectal anastomosis
• Staple-line
• Tensile strength

• Animals
• Female
• Anastomosis, Surgical/adverse effects
• Anastomotic Leak/prevention & control
• Anastomotic Leak/etiology
• Caproates
• Lactones
• Rectum/surgery
• Surgical Stapling
• Swine

• University of Southern Denmark

• anastomotic leak
• external coating
• sealant

• Animals
• Humans
• Anastomosis, Surgical/methods
• Anastomotic Leak/prevention & control
• Biocompatible Materials
• Collagen
• Fibrin Tissue Adhesive

• carbon black
• gallic acid-conjugated chitosan
• self-healing
• shear-thinning
• suture support
• tissue adhesives

• 2021 Wonkwang University

• Anastomotic leakage
• Colorectal anastomosis
• Complications
• Postoperative outcome
• Tissue adhesives
• Tissue sealants

• Humans
• Tissue Adhesives/pharmacology
• Tissue Adhesives/therapeutic use
• Anastomosis, Surgical/adverse effects
• Anastomosis, Surgical/methods
• Anastomotic Leak/etiology
• Anastomotic Leak/prevention & control
• Wound Healing
• Colorectal Neoplasms/surgery

• Inferior mesenteric artery
• Left colic artery
• Ligation
• Rectal cancer
• Resection

• Humans
• Retrospective Studies
• Postoperative Complications/epidemiology
• Mesenteric Artery, Inferior/surgery
• Rectal Neoplasms/surgery
• China
• Laparoscopy

• Anastomotic leakage
• Nomogram prediction model
• Rectal cancer
• Risk factor

• Anastomosis
• Anastomotic leakage
• Colorectal surgery
• Reinforcement
• Sealant

• No coil
• anastomotic leak
• colorectal cancer
• laparoscopy
• paralytic ileus

• Male
• Humans
• Female
• Anastomotic Leak/etiology
• Anastomotic Leak/surgery
• Retrospective Studies
• Rectal Neoplasms/surgery
• Anastomosis, Surgical/adverse effects
• Laparoscopy/adverse effects
• Intestinal Pseudo-Obstruction/etiology
• Intestinal Pseudo-Obstruction/surgery

Anastomotic leakage (AL) is one of most severe postoperative complications following low anterior resection (LAR) for rectal cancer, and has an adverse impact on postoperative recovery. The occurence of AL is associated with several factors, while few studies explored the role of intracorporeal barbed suture reinforcement in it.

Consecutive cases underwent laparoscopic LAR for rectal cancer from Mar. 2018 to Feb. 2021 in our center were retrospectively collected. Cases were classified into the intracorporeal barbed suture reinforcement group and the control group according to whether performing intracorporeal reinforcement with barbed suture, and AL incidences were compared between two groups. Propensity score matching (PSM) was then performed based on identified risk factors to reduce biases from covariates between two groups. AL incidences in the matched cohort were compared.

A total of 292 cases entered into the study, and AL incidences were significantly lower in the intracorporeal barbed suture reinforcement group compared with the control group (10.00% vs 2.82%, P = 0.024). Sex, BMI, preoperative adjuvant chemoradiotherapy and anastomotic level were chose for PSM analyses based on previous studies. In the matched cohort, the AL incidences were still significantly lower in the intracorporeal barbed suture reinforcement group (10.57% vs 2.44%, SD = 0.334).

Intracorporeal barbed suture reinforcement is associated with low AL incidences after laparoscopic LAR for rectal cancer, which is a potential procedure for reducing AL and worthy of application clinically.

The online version contains supplementary material available at 10.1186/s12893-022-01782-x.

To explore the risk factors of anastomotic leakage (AL) after laparoscopic anterior resection (AR) of rectal cancer and establish a nomogram prediction model.

Clinical and surgical data of patients who underwent AR of rectal cancer at Sichuan Cancer Hospital from January 2017 to December 2020 were retrospectively collected. Univariate and multivariate logistic regression analyses were used to screen the independent risk factors of AL after AR. A nomogram risk prediction model was established based on the selected independent risk factors and the predictive performance of nomogram was evaluated.

A 1013 patients undergoing laparoscopic AR were included, of which 67 had AL, with an incidence of 6.6%. Univariate and multivariate logistic regression analyses showed that male gender, tumors distance from the anus verge of ≤ 5cm, tumors distance from the anus verge of 5–10cm, circumferential tumor growth, operation time ≥ 240min, and no diverting stoma were independent risk factors for AL after AR. A nomogram prediction model was established based on these results. The calibration curve showed that the predicted occurrence probability of the nomogram model was in good agreement with the actual occurrence probability. The area under the receiver operating characteristic (ROC) curve was 0.749.

The nomogram prediction model based on the independent risk factors of patients undergoing AL after AR can effectively predict the probability of AL.

• colorectal cancer
• indocyanine green
• minimally invasive surgery
• nearinfrared fluorescence
• perfusion

• anastomotic leakage (AL)
• coated collagen patch
• fibrin glue (FG)
• fibrin sealant
• intestinal anastomoses

• Bavarian Research Foundation

Laparoscopic low anterior rectal resection is the most widely used surgical procedure for middle and low rectal cancer. The aim of this study was to investigate the feasibility and safety of the extracorporeal placement of the anvil in preserving the left colic artery in laparoscopic low anterior rectal resection without auxiliary incisions for transanal specimen retrieval in this research.

Clinical data and follow-up data of patients undergoing laparoscopic low anterior rectal resection from January 2017 to October 2020 were collected. The resections were modified such that the resisting nail holder was extracorporeally placed for the transanal exenteration of the specimen without using auxiliary abdominal incisions while preserving the left colic artery. By analyzing the data of anastomotic stenosis, anastomotic bleeding and anastomotic fistulas after surgery, the advantages and disadvantages of this surgical method for patients were clarified.

A total of 22 patients were enrolled. Five of 22 patients simultaneously underwent double-barrel terminal ileostomy. The postoperative exhaust time was 2–7 (median, 3) days. Postoperative anastomotic bleeding occurred in one patient, postoperative anastomotic fistula occurred in four patients, and postoperative anastomotic stenosis occurred in six patients. There were four patients with postoperative distant metastasis, of which three had concomitant local recurrence. Seventeen patients had no obvious symptoms or signs of recurrent metastases during follow-up appointments, and one died of liver failure.

Modified laparoscopic low anterior rectal resection, which resects the specimen through anus eversion by inserting the anvil extracorporeally while preserving the left colic artery, is safe and feasible for patients with low rectal cancer.

• Laparoscopy
• Natural orifice specimen extraction surgery
• Preservation of left colic artery
• Rectal malignant tumour

Hand-sewn anastomosis is an essential and fundamental skill for surgeons dealing with any gastrointestinal anastomosis. Despite the advances in minimally invasive surgery and stapling devices, there are still complex surgical circumstances when the surgeon’s surgical know-how are necessary. Therefore, a safe hand-sewn technique for bowel anastomosis is required to establish a tension-free, well-perfused, and sealed anastomosis that allows gastrointestinal continuity with no unexpected complications. We describe a step-by-step procedure for hand-sewn double-layered anastomosis that reflects these principles and is practical for small and large bowel anastomosis.

• Anastomotic leak
• Operative surgical procedures
• Surgical anastomosis

• anastomosis
• anastomotic leak
• bowel perfusion
• colorectal surgery
• endoscopy

The development of bio-glues is still a challenging task, regarding adhesion on wet surfaces; often, high performance and adaption to complex geometries need to be combined in one material. Here, we report biocompatible adhesives obtained by blending regenerated silk (RS) with a soluble plant-derived polyphenol (i.e., chestnut tannin) that was also used to exfoliate graphite to obtain graphene-based RS/tannin (G-RS/T) composites. The resultant G-RS/T hybrid material exhibited outstanding stretchability (i.e., 400%) and high shear strength (i.e., 180 kPa), superior to that of commercial bio-glues, and showed sealant properties for tissue approximation. Moreover, we showed how such nanocomposites exhibit electromechanical properties that could potentially be used for the realization of green and eco-friendly piezoelectric devices. Finally, we demonstrate the in vitro glue’s biocompatibility and anti-oxidant properties that enable their utilization in clinical applications.

• adhesion
• biocompatibility
• exfoliated graphite
• mechanical properties
• regenerated silk
• tannin extracts

Anastomotic leakage (AL) is a frequent complication after laparoscopic rectal cancer resection (LRCR). The main objective of the present study was to identify accurate indicators of AL after LRCR.

A retrospective case-control study was performed of 185 patients who underwent laparoscopic surgery for rectal cancer between March 2012 and February 2017 at Beijing Friendship Hospital. Potential indicators of AL were examined via univariate and multivariate analyses. The performance of multivariate analysis was evaluated using receiver operating characteristic (ROC) curves.

The overall AL rate was 17.84%. Multivariate analysis identified drainage smell (odds ratio [OR = 35.318, 95% confidence interval [CI] = 7.114 to 175.338) and peritonitis [OR = 17.475, 95% CI = 1.540 to 198.318) as independent indicators of AL. The area under the ROC curve was 0.720 (95% CI = 0.606 to 0.835).

Drainage smell and peritonitis could be reliable and accurate indicators of AL after LRCR.

• Anastomotic leakage
• drainage smell
• efficient indicator
• laparoscopic surgery
• peritonitis
• rectal cancer

Despite the technical limitations of minimally invasive surgery, laparoscopic total mesorectal excision (LTME) for rectal cancer has short-term advantages over open surgery, but the pathological outcomes reported in randomized clinical trials are still in controversy. Minimally invasive robotic total mesorectal excision (RTME) has recently been gaining popularity as robotic surgical systems potentially provide greater benefits than LTME. Compared to LTME, RTME is associated with lower conversion rates and similar or better genitourinary functions, but its long-term oncological outcomes have not been established. Although the operating time of RTME is longer than that of LTME, RTME has a shorter learning curve, is more convenient for surgeons, and is better for sphincter-preserving operations than LTME. The robotic surgical system is a good technical tool for minimally invasive surgery for rectal cancer, especially in male patients with narrow deep pelvises. Robotic systems and robotic surgical techniques are still improving, and the contribution of RTME to the treatment of rectal cancer will continue to increase in the future.

• Rectal neoplasms
• Robotic surgical procedures
• Total mesorectal excision

• anastomotic leakage
• fistula
• laparoscopic colectomy
• reoperation
• stoma

We investigated the correlations between surgery-related factors and the incidence of anastomotic leakage after low anterior resection (LAR) for lower rectal cancer.

A total of 630 patients underwent colorectal surgery between 2011 and 2014 in our department. Of these, 97 patients (15%) underwent LAR and were enrolled in this retrospective study. Temporary ileostomy was performed in each patient.

Anastomotic leakage occurred in 21 patients (21.7%). Univariate analysis showed a significant association between operative duration (p = 0.005), transanal hand-sewn anastomosis (p = 0.014), and operation procedure (p = 0.019) and the occurrence of leakage. Multivariate regression reanalysis showed that underlying disease (p = 0.044), transanal hand-sewn anastomosis (p = 0.019) and drain type (p = 0.025) were significantly associated with the occurrence of leakage. The propensity-score analysis showed that closed drainage were 6.3 times more likely to have anastomotic leakage than open drainage in relation to the amount of postoperative drainage (ml), according to the inverse probability of treatment-weighted analysis.

Our results indicate that underlying disease, transanal hand-sewn anastomosis, and closed drain may be a risk and predictive factors for anastomotic leakage after LAR for lower rectal cancer. The notable finding was that closed drainage was related to the occurrence of anastomotic leakage and closed drainage was correlated with less volume of postoperative drain discharge than open drain.

• Drain type
• Low anterior resection
• Lower rectal cancer
• Postoperative leakage

• Anastomotic leakage
• Laparoscopy
• Rectal cancer
• Stapler firings
• Stapler number

• Anastomosis, Surgical/adverse effects
• Anastomotic Leak/etiology
• Anastomotic Leak/prevention & control
• Anastomotic Leak/surgery
• Humans
• Laparoscopy
• Rectal Neoplasms/surgery
• Rectum/surgery
• Risk Factors
• Surgical Stapling/adverse effects

• Computed tomography
• Outcome
• Pelvimetry
• Rectal neoplasms
• Surgery

• anastomotic leakage
• low anterior resection
• modified Glasgow Prognostic Score
• multiple stapler firings
• rectal cancer

Postoperative anastomotic leaks remain a common and serious complication of colorectal surgeries and are a major cause of mortality and morbidity of these procedures. Anastomotic leaks (AL) have been extensively studied; however, there has been no significant reduction in their prevalence over time. In addition, there is a significant economic burden from AL attributed to the need for repeat surgery, radiologic intervention and lengthened hospital stay. We conducted a comparative cost analysis of patients undergoing colorectal surgery with anastomosis, with the application of fibrin sealant (FS) to the sutured anastomosis versus not treating the sutured anastomosis with FS.

The deterministic decision-tree model was populated with clinical data including operating room time, hospitalization days, occurrence of AL, need for revision surgery, blood products and radiologic interventions to treat the AL in lower colorectal surgery. A systematic literature review was conducted to identify appropriate studies with these variables.

The average cost per case treated lower colorectal surgery with fibrin sealant glue 10 mL Tisseel^® and those not treated with a fibrin sealant after suturing the anastomoses was €3233 and €4130, respectively, for resource expenses paid by the healthcare system. This would suggest potential savings of €897 per surgery, achieved through the application of FS to the sutured anastomosis for preventing AL following colorectal surgery.

Application of FS to the sutured anastomosis in lower colorectal surgery resulted in a decrease in post-operative AL, and cost savings based on a reduction in hospitalization days, a reduction needing: revision surgery, radiologic intervention and blood products to treat AL.

• anastomoses
• budget impact
• colorectal cancer
• colorectal surgery
• cost analysis
• fibrin sealant

• Anastomotic leakage
• abdominal aortic calcification
• rectal cancer

In recent years, laparoscopic surgery has been widely used for rectal cancer. In laparoscopic rectal surgery, a double-stapling technique (DST) anastomosis using a stapling device is considered a relatively difficult procedure. Postoperative anastomotic leakage (AL) is a major complication related to patients’ quality of life and prognosis.

This study was a retrospective, single-institution study of 101 rectal cancer patients who underwent laparoscopic low anterior resection (LAR) with DST anastomosis (excluding simultaneous resection of other organs and construction of protective diverting stoma) between February 2008 and November 2017 at the Gifu University Graduate School of Medicine. This study aimed to identify risk and early predictive factors of AL.

Among 101 patients, symptomatic AL occurred in 13 patients (12.9%), of whom 10 were male and 3 were female. Their median BMI was 22.7 kg/m² (range, 17.9–26.4 kg/m²).

Among the pre- and intraoperative factors, AL was significantly associated with tumor location (lower rectum), distance from the anal verge (< 6 cm), intraoperative blood loss (≥ 50 ml), and the number of linear staples (≥ 2) in univariate analysis. In multivariate analysis, only intraoperative blood loss (≥ 50 ml, odds ratio [OR] 4.59; 95% confidence interval [CI] 1.04–19.52; p = 0.045) was identified as an independent risk factor for AL.

Among the postoperative factors, AL was significantly associated with tachycardia-POD1 (≥ 100 bpm), CRP-POD3 (≥ 15 mg/dl), fever on postoperative day (fever-POD) 3 (≥ 38 °C), and first defecation day after surgery (< POD3) in univariate analysis. In multivariate analysis, fever-POD3 (≥ 38 °C, OR 30.97; 95% CI 4.68–311.22; p = 0.0003) and first defecation day after surgery (< POD3, OR 5.82; 95% CI 1.34–31.30; p = 0.019) were identified as early predictive factors for AL.

In this study, intraoperative blood loss was an indicator of difficulty in a transection and anastomosing procedure, and fever-POD3 and early first defecation day after surgery were independent early predictive factors for AL. Careful surgery using an appropriate technique and standardized procedures with minimal bleeding and careful postoperative management paying attention to fever and defecation may prevent the onset and severity of AL.

• Anastomotic leakage
• Double-stapling technique
• Laparoscopic low anterior resection
• Rectal cancer

Anastomosis is a crucial step in radical cancer surgery. Despite being a daily practice in gastrointestinal surgery, anastomotic leakage (AL) stands as a frequent postoperative complication. Because of increased morbidity, mortality, combined with longer hospital stay, the rate of re-intervention, and poor oncological outcomes, AL is considered the most feared and life-threatening complication after colorectal resections. Furthermore, poor functional outcomes with a higher rate of a permeant stoma in 56% of patients this could negatively affect the patient’s quality of life. This a narrative review which will cover intraoperative anastomotic integrity assessment and preventive measures in order to reduce AL. Although the most important prerequisites for the creation of anastomosis is well-perfused and tension-free anastomosis, surgeons have proposed several preventive measures, which were assumed to reduce the incidence of AL, including antibiotic prophylaxis, intraoperative air leak test, omental pedicle flap, defunctioning stoma, pelvic drain insertion, stapled anastomosis, and general surgical technique. However, lack of clear evidence of which preventive measures is superior over the other combined with the fact that the decision remains based on the surgeon’s choice. Despite the advances in surgical techniques, AL remains a serious health problem associated with increased morbidity, mortality with additional cost. Many preventative measures were employed with no clear evidence supporting the superiority of stapled anastomosis over hand-Sewn anastomosis, coating of the anastomosis, or pelvic drain. Defunctioning stoma, when justified it could decrease the leakage-related complications and the incidence of reoperation. MBP combined with oral antibiotics still recommended.

• Anastomotic leakage
• Colorectal
• Resection
• Anastomosis
• Cancer
• Anastomotic disruption

• Anastomotic leakage
• Colorectal surgery
• Diverting stoma
• Laparoscopic colorectal surgery
• Laparoscopy
• Rectal cancer
• Risk factor

• Anastomosis, Surgical/adverse effects
• Anastomosis, Surgical/methods
• Anastomotic Leak/epidemiology
• Anastomotic Leak/etiology
• Colon/microbiology
• Colon/surgery
• Colonic Diseases/surgery
• Colorectal Surgery/adverse effects
• Colorectal Surgery/methods
• Gastrointestinal Microbiome
• Humans
• Incidence
• Laparoscopy/adverse effects
• Laparoscopy/methods
• Perioperative Period
• Rectum/microbiology
• Rectum/surgery
• Risk Factors

Objectives: To clarify the surgical outcomes and risk factors for anastomotic leakage (AL) following laparoscopic anterior resection (Lap-AR) for the treatment of rectal cancer. Methods: We retrospectively reviewed the records of 175 consecutive primary rectal cancer patients who had undergone Lap-AR at our institution between April 2012 and November 2015. Patient, tumor, and surgical variables were analyzed using univariate analyses. Results: Of 175 patients, 116 were men (66.3%). All four patients who had AL (2.3%) were men and current smokers with heavy smoking histories. In three of the AL cases, preoperative total colonoscopy was impossible owing to tumor obstruction, and the other case had concomitant obstructive colitis after oral bowel preparation. Univariate analysis identified tumor size, tumor obstruction, and smoking history as factors significantly associated with AL development. Conclusions: Tumor size, tumor obstruction, and smoking history were risk factors for AL following Lap-AR for the treatment of primary rectal cancer.

• anastomotic leakage
• laparoscopic surgery
• rectal cancer
• smoking
• tumor obstruction

Although many surgical strategies have been used to reduce the anastomotic leak (AL) rate after laparoscopic rectal cancer surgery, limited data are available on the risk factors for AL and the effective strategy to reduce AL.

The present study enrolled 736 consecutive patients who underwent laparoscopic resection without a diverting stoma for rectal adenocarcinoma. A nomogram was constructed to predict AL. Based on the nomogram, personalized risk was calculated and sequential surgical strategies were monitored using risk-adjusted cumulative sum (RA-CUSUM) analysis.

Among the 736 patients, clinical AL occurred in 65 patients (8.8%). Sex, an American Society of Anesthesiologists score, operation time, blood transfusion, and tumor location were identified as significant predictive factors for AL. Based on these factors, a nomogram was created to predict AL, with a concordance index (C-index) of 0.753 (95% confidence interval, 0.690–0.816). A calibration plot showed good statistical performance on internal validation (bias-corrected C-index of 0.742). The RA-CUSUM curve showed that extended splenic flexure mobilization (SFM) could be the most influential strategy to reduce AL.

Our nomogram for predicting AL after laparoscopic rectal cancer surgery might be helpful to identify the individual risk of AL. Furthermore, extended SFM might be the most appropriate strategy for reducing AL.

• Anastomotic leakage
• low anterior resection
• minimally invasive rectal cancer surgery
• rectal tube drainage
• transanal drainage

• Consensus
• Gastrointestinal anastomotic leakage
• International Multispecialty Anastomotic Leak Global Improvement Exchange
• Morbidity
• Review

• Gastrointestinal surgery
• TachoSil
• anastomosis
• anastomotic leak
• fibrin sealants
• fibrin tissue adhesive

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Female
• Fibrinogen/administration & dosage
• Gastrectomy/adverse effects
• Gastrectomy/methods
• Hemostasis, Surgical/methods
• Humans
• Incidence
• Italy/epidemiology
• Male
• Middle Aged
• Postoperative Hemorrhage/epidemiology
• Postoperative Hemorrhage/etiology
• Postoperative Hemorrhage/prevention & control
• Stomach Neoplasms/surgery
• Surgical Sponges
• Thrombin/administration & dosage
• Young Adult

Anastomotic leakage (AL) is one of the most devastating complications after rectal cancer surgery. The double stapling technique has greatly facilitated intestinal reconstruction especially for anastomosis after low anterior resection (LAR). Risk factor analyses for AL after open LAR have been widely reported. However, a few studies have analyzed the risk factors for AL after laparoscopic LAR. Laparoscopic rectal surgery provides an excellent operative field in a narrow pelvic space, and enables total mesorectal excision surgery and preservation of the autonomic nervous system with greater precision. However, rectal transection using a laparoscopic linear stapler is relatively difficult compared with open surgery because of the width and limited performance of the linear stapler. Moreover, laparoscopic LAR exhibits a different postoperative course compared with open LAR, which suggests that the risk factors for AL after laparoscopic LAR may also differ from those after open LAR. In this review, we will discuss the risk factors for AL after laparoscopic LAR.

• Risk factor
• Laparoscopic low anterior resection
• Anastomotic leakage

• Anastomosis, Surgical/methods
• Anastomotic Leak/epidemiology
• Anti-Bacterial Agents/therapeutic use
• Blood Loss, Surgical
• Chemoradiotherapy/statistics & numerical data
• Colostomy/statistics & numerical data
• Digestive System Surgical Procedures/methods
• Drainage
• Drug Therapy/statistics & numerical data
• Gastrointestinal Microbiome
• Humans
• Intraoperative Care
• Neoadjuvant Therapy/statistics & numerical data
• Obesity/epidemiology
• Operative Time
• Postoperative Care
• Preoperative Care
• Radiotherapy/statistics & numerical data
• Rectal Neoplasms/pathology
• Rectal Neoplasms/surgery
• Rectum/blood supply
• Rectum/surgery
• Risk Factors
• Sex Factors
• Surgical Stapling/methods
• Tumor Burden

• Anastomotic leakage
• Meta-analysis
• Prognosis
• Risk factors

• Cancer
• Clinical endoscopy
• Clinical research
• Clinical trials
• Colorectal < clinical papers

• Anal Canal/surgery
• Anastomosis, Surgical/adverse effects
• Anastomotic Leak/epidemiology
• Anastomotic Leak/etiology
• Colectomy/adverse effects
• Colectomy/methods
• Global Health
• Humans
• Laparoscopy/adverse effects
• Rectal Neoplasms/surgery
• Risk Assessment
• Risk Factors

• Adenocarcinoma/pathology
• Adenocarcinoma/therapy
• Adult
• Aged
• Aged, 80 and over
• Chemoradiotherapy
• Female
• Fluorodeoxyglucose F18
• Follow-Up Studies
• Humans
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Neoadjuvant Therapy
• Neoplasm Staging
• Positron-Emission Tomography
• Prognosis
• Prospective Studies
• ROC Curve
• Radiopharmaceuticals
• Rectal Neoplasms/pathology
• Rectal Neoplasms/therapy
• Retrospective Studies
• Tomography, X-Ray Computed

• Rectal surgery
• complications
• laparoscopic

• Anastomosis
• Laparoscopic
• Rectal cancer