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Background <p>Radiotherapy is a well-recognized risk factor of acute leakage after colorectal surgery. However, its relationship with delayed leakage remains unclear.</p> <p>The aim of this systemic review and meta-analysis was to determine its association with delayed anastomotic leakage (DAL) after rectal surgery.</p> Methods <p>A comprehensive literature search was conducted across seven international databases (PubMed, Embase, Cochrane CENTRAL, ClinicalKeys, EBSCOhost-CINAHL, Web of Science, and Google Scholar), five Chinese/Taiwanese databases, the ProQuest Dissertations, and three Grey literature databases. All studies that reported DAL where radiotherapy and nonradiotherapy study groups were included.</p> <p>The random-effect model was used to combine data. Data were presented as odds-ratios (ORs) with 95% confidence intervals (CI). The main outcome measured was DAL.</p> Results <p>Six comparative series involving a total of 4991 patients were analyzed. DAL was identified in 323 cases, occurring between 22 and 2059 days post-operation. The results revealed a statistically significant increase in the risk of DAL following radiotherapy (OR = 5.208; 95% CI = 3.241-8.371; <i>p</i> &lt; 0.001). Heterogeneity was observed across the included studies (Cochran Q = 12.769 (<i>p</i>=0.026), I<sup>2</sup>=60.844%, Tau<sup>2</sup> = 0.188, predictive interval (PI) = 5.208, 95% PI = 1.313-20.665).</p> Conclusions <p>Radiotherapy is a potential risk factor for DAL after anterior resection and low anterior resection.</p>

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Radiotherapy as a potential risk factor for delayed anastomotic leakage after rectal surgery: a meta-analysis

  • 期刊论文

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  • 发表日期：

    2025年10月22日

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  • Jau-Jie You,
  • Abe Fingerhut,
  • Yi-Chang Chen,
  • William Tzu-Liang Chen,
  • Ming-Yin Shen

摘要

Background

Radiotherapy is a well-recognized risk factor of acute leakage after colorectal surgery. However, its relationship with delayed leakage remains unclear.

The aim of this systemic review and meta-analysis was to determine its association with delayed anastomotic leakage (DAL) after rectal surgery.

Methods

A comprehensive literature search was conducted across seven international databases (PubMed, Embase, Cochrane CENTRAL, ClinicalKeys, EBSCOhost-CINAHL, Web of Science, and Google Scholar), five Chinese/Taiwanese databases, the ProQuest Dissertations, and three Grey literature databases. All studies that reported DAL where radiotherapy and nonradiotherapy study groups were included.

The random-effect model was used to combine data. Data were presented as odds-ratios (ORs) with 95% confidence intervals (CI). The main outcome measured was DAL.

Results

Six comparative series involving a total of 4991 patients were analyzed. DAL was identified in 323 cases, occurring between 22 and 2059 days post-operation. The results revealed a statistically significant increase in the risk of DAL following radiotherapy (OR = 5.208; 95% CI = 3.241-8.371; p < 0.001). Heterogeneity was observed across the included studies (Cochran Q = 12.769 (p=0.026), I2=60.844%, Tau2 = 0.188, predictive interval (PI) = 5.208, 95% PI = 1.313-20.665).

Conclusions

Radiotherapy is a potential risk factor for DAL after anterior resection and low anterior resection.