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World J Gastrointest Surg. Sep 27, 2026; 18(9): 123355
Published online Sep 27, 2026. doi: 10.4240/wjgs.123355
Published online Sep 27, 2026. doi: 10.4240/wjgs.123355
Preventive drainage and anastomotic leakage after colorectal surgery
Xia-Ling Shi, Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, Shenyang 110032, Liaoning Province, China
Long-Sheng Cai, Department of Ophthalmology, Longchuan County People’s Hospital, Heyuan 517300, Guangdong Province, China
Ling-Jie Zhang, Department of Traditional Chinese Medicine, Longchuan County People’s Hospital, Heyuan 517300, Guangdong Province, China
Li Zhang, Department of Colorectal Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, Guangdong Province, China
Co-first authors: Xia-Ling Shi and Long-Sheng Cai.
Co-corresponding authors: Ling-Jie Zhang and Li Zhang.
Author contributions: Shi XL, Cai LS, Zhang LJ, and Zhang L contributed to the investigation; Shi XL and Zhang L contributed to the conceptualization, writing of the original draft, and review and editing; Shi XL and Cai LS contributed to the writing; Cai LS, Zhang LJ, and Zhang L contributed to the methodology; Zhang LJ and Zhang L contributed to the resources; Cai LS contributed to the validation, formal analysis, data curation, software, and visualization; All authors approved the final version to publish. Shi XL and Cai LS contributed equally as co-first authors. Zhang LJ and Zhang L contributed equally as co-corresponding authors.
AI contribution statement: Portions of this manuscript were edited using artificial intelligence tools solely for language refinement. The authors carefully reviewed and verified all AI-assisted outputs and take full responsibility for the scientific content of the manuscript.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Li Zhang, MD, Department of Colorectal Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, No. 111 Dade Road, Yuexiu District, Guangzhou 510120, Guangdong Province, China. tension1000@126.com
Received: May 18, 2026
Revised: June 30, 2026
Accepted: July 31, 2026
Published online: September 27, 2026
Processing time: 121 Days and 12.7 Hours
Revised: June 30, 2026
Accepted: July 31, 2026
Published online: September 27, 2026
Processing time: 121 Days and 12.7 Hours
Core Tip
Core Tip: This meta-analysis evaluated whether preventive drainage reduces anastomotic leakage after colorectal surgery and stratified outcomes by drainage modality. Thirty-six studies comprising 17690 patients were included. The overall reduction in leakage risk was primarily driven by transanal drainage. Pelvic drainage and other drainage methods showed no statistically significant preventive effect. These findings suggest that preventive drainage should not be considered a uniform strategy, and that the choice of modality should be based on drainage modality, anastomotic level, operative setting, and patient risk.