|Anastomotic leak is a major concern in obese patients because they may experience more intraoperative technical difficulties, comorbidities, and healing delays secondary to neoadjuvant chemoradiation (NCRT). However, the majority of studies included in this review that evaluated this concern in CRC or only rectal cancer did not report any significant differences between obese and non-obese patients. One study showed a higher leak rate in obese patients who did or did not undergo NCRT vs. non-obese patients (14 vs. 5, respectively; p=0.003). But this is related only to mid to lower rectal anastomoses and only 25 of 571 underwent laparoscopy. The authors discussed that the technical complexity expected in obese patients and the low tumor location explain the increased anastomotic leak rate
Open access to the scientific literature means the removal of barriers (including price barriers) from accessing scholarly work. There are two parallel âroadsâ towards open access: Open Access articles and self-archiving. Open Access articles are immediately, freely available on their Web site, a model mostly funded by charges paid by the author (usually through a research grant). The alternative for a researcher is âself-archivingâ (i.e., to publish in a traditional journal, where only subscribers have immediate access, but to make the article available on their personal and/or institutional Web sites (including so-called repositories or archives)), which is a practice allowed by many scholarly journals.
Open Access rises practical and policy questions for scholars, publishers, funders, and policymakers alike, including what the return on investment is when paying an article processing fee to publish in an Open Access articles, or whether investments into institutional repositories should be made and whether self-archiving should be made mandatory, as contemplated by some funders.