Reviewer ’s report  
 
Title: Analysis of Risk Factor for Anastomotic Leakage after Lower Rectal Cancer 
Resection,  Including Drain Type: A Retrospective Single -Center Study  
 
Version: 1 Date: 13 Jun 2020  
 
Reviewer's report:  
 
Authors did a retrospective analysis for identification of risk factors for anastomotic Leakage 
after lower rectal cancer resection. However, there are few concerns which needs to be 
answered.  
 
1) How did they conclude that open drainage system was responsible for reduced 
anastomotic leak, when there was no significant difference between drain output in 
anastomotic leak group vs no leak group (Table 2 as  well as Table 3 - No significance).  
2) The p value on univariate analysis for drainage system was not significant, they 
how it was used for multivariate analysis.  
3) Operative procedure was a significant factor in univariate analysis but it was not 
analyze d in multivariate analysis. Please consult statistician.  
4) In patients with closed drainage, how many patients had colo -anal anastomosis, ISR 
and hand sewn anastomosis? These are confounding factors and should have been mentioned.  
5) Standard terms shoul d be used e.g ultra low LAR instead of super low LAR, Rb 
positive lesions  
6) Also, well -formed sentences should be used and grammatical errors corrected.  
7) Provide reference for this: We previously experienced patients with continued 
anastomotic leakage after changing from open to closed drainage after LAR for lower rectal 
cancer  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in th e manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I recommend additional statistical review  
Qual ity of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following ques tions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from 
an organisation that may in any way gain or lose financially from the publication of 
this manuscript, either now or in the future?  
 
2. Do you hold any stocks or  shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of 
the manuscript?  
 
4. Have yo u received reimbursements, fees, funding, or salary from an organization that  
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing int erests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
Reviewer Publication Consent. I agree for my report to be made available under an Open 
Access  Creative Commons CC -BY License ( http://creativecommons.org/licenses/by/4.0 ) if 
this manuscript  is accepted for publication. Any comments that I do not wish to be included 
in the published  report have been included as confidential comments to the editor, which will 
not be published.  If you are not happy for us to publish this report, please contact the editorial 
office before completing  the review.  If you wish, you ca n include your name in your 
published report. Please note you must  decide whether to include your name at the start of the 
process and confirm this decision whenever  prompted. If you change your decision later, we 
will not be able to publish your name.  
 
I agree to the terms of the CC -BY 4.0 license; please do not publish my name with my 
report.  
(default)  
 
 
 
 
 
 
Publons Reviewer Recognition . Springer Nature can send verification of this review directly 
to Publons (a subsidiary of Clarivate Analytics). If you would l ike to take advantage of this 
service,  please click on the “Yes” option below. Your name, email address, title of the 
reviewed  manuscript, name of the journal, and date of your review submission (the “Review 
Data”) will  then be transmitted to Publons upon publication of the manuscript. If you have 
already registered  at Publons, they will notify you of the receipt of this review and update 
your profile as per your  settings and their policy. If you are not registered with Publons, you 
will receive an email fr om them asking you to register in order for them to be able to 
recognize your review on your new  profile page. Publons may use the Review Data to 
generate derivative metadata for the benefit of  Publons and you as a reviewer, carefully 
considering the sensi tivity of such information. For  example, Publons may verify your record 
as a reviewer by updating your profile published on its  webservice if you have registered for 
such service or help editors to identify candidate reviewers.  Please find the details of 
processing in Publons ’ privacy policy https://publons.com/about/terms  
 
Yes 
Reviewer ’s report  
 
Title: Analysis of Risk Factor for Anastomotic Leakage after Lower Rectal Cancer 
Resection,  Including Drain Type: A Retrospective Single -Center Study  
 
Version: 1 Date: 13 Jun 2020  
 
Reviewer's report:  
 
Authors did a retrospective analysis for identification of risk factors for anastomotic Leakage 
after lower rectal cancer resection. However, there are few concerns which needs to be 
answered.  
 
1) How did they conclude that open drainage system was responsible for reduced 
anastomotic leak, when there was no significant difference between drain output in 
anastomotic leak group vs no leak group (Table 2 as  well as Table 3 - No significance).  
2) The p value on univariate analysis for drainage system was not significant, they 
how it was used for multivariate analysis.  
3) Operative procedure was a significant factor in univariate analysis but it was not 
analyze d in multivariate analysis. Please consult statistician.  
4) In patients with closed drainage, how many patients had colo -anal anastomosis, ISR 
and hand sewn anastomosis? These are confounding factors and should have been mentioned.  
5) Standard terms shoul d be used e.g ultra low LAR instead of super low LAR, Rb 
positive lesions  
6) Also, well -formed sentences should be used and grammatical errors corrected.  
7) Provide reference for this: We previously experienced patients with continued 
anastomotic leakage after changing from open to closed drainage after LAR for lower rectal 
cancer  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in th e manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I recommend additional statistical review  
Qual ity of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following ques tions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from 
an organisation that may in any way gain or lose financially from the publication of 
this manuscript, either now or in the future?  
 
2. Do you hold any stocks or  shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of 
the manuscript?  
 
4. Have yo u received reimbursements, fees, funding, or salary from an organization that  
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing int erests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
Reviewer Publication Consent. I agree for my report to be made available under an Open 
Access  Creative Commons CC -BY License ( http://creativecommons.org/licenses/by/4.0 ) if 
this manuscript  is accepted for publication. Any comments that I do not wish to be included 
in the published  report have been included as confidential comments to the editor, which will 
not be published.  If you are not happy for us to publish this report, please contact the editorial 
office before completing  the review.  If you wish, you ca n include your name in your 
published report. Please note you must  decide whether to include your name at the start of the 
process and confirm this decision whenever  prompted. If you change your decision later, we 
will not be able to publish your name.  
 
I agree to the terms of the CC -BY 4.0 license; please do not publish my name with my 
report.  
(default)  
 
 
 
 
 
 
Publons Reviewer Recognition . Springer Nature can send verification of this review directly 
to Publons (a subsidiary of Clarivate Analytics). If you would l ike to take advantage of this 
service,  please click on the “Yes” option below. Your name, email address, title of the 
reviewed  manuscript, name of the journal, and date of your review submission (the “Review 
Data”) will  then be transmitted to Publons upon publication of the manuscript. If you have 
already registered  at Publons, they will notify you of the receipt of this review and update 
your profile as per your  settings and their policy. If you are not registered with Publons, you 
will receive an email fr om them asking you to register in order for them to be able to 
recognize your review on your new  profile page. Publons may use the Review Data to 
generate derivative metadata for the benefit of  Publons and you as a reviewer, carefully 
considering the sensi tivity of such information. For  example, Publons may verify your record 
as a reviewer by updating your profile published on its  webservice if you have registered for 
such service or help editors to identify candidate reviewers.  Please find the details of 
processing in Publons ’ privacy policy https://publons.com/about/terms  
 
Yes 
Please review this paper.
user
Reviewer ’s report  
 
Title: Analysis of Risk Factor for Anastomotic Leakage after Lower Rectal Cancer 
Resection,  Including Drain Type: A Retrospective Single -Center Study  
 
Version: 1 Date: 13 Jun 2020  
 
Reviewer's report:  
 
Authors did a retrospective analysis for identification of risk factors for anastomotic Leakage 
after lower rectal cancer resection. However, there are few concerns which needs to be 
answered.  
 
1) How did they conclude that open drainage system was responsible for reduced 
anastomotic leak, when there was no significant difference between drain output in 
anastomotic leak group vs no leak group (Table 2 as  well as Table 3 - No significance).  
2) The p value on univariate analysis for drainage system was not significant, they 
how it was used for multivariate analysis.  
3) Operative procedure was a significant factor in univariate analysis but it was not 
analyze d in multivariate analysis. Please consult statistician.  
4) In patients with closed drainage, how many patients had colo -anal anastomosis, ISR 
and hand sewn anastomosis? These are confounding factors and should have been mentioned.  
5) Standard terms shoul d be used e.g ultra low LAR instead of super low LAR, Rb 
positive lesions  
6) Also, well -formed sentences should be used and grammatical errors corrected.  
7) Provide reference for this: We previously experienced patients with continued 
anastomotic leakage after changing from open to closed drainage after LAR for lower rectal 
cancer  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in th e manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I recommend additional statistical review  
Qual ity of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following ques tions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from 
an organisation that may in any way gain or lose financially from the publication of 
this manuscript, either now or in the future?  
 
2. Do you hold any stocks or  shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of 
the manuscript?  
 
4. Have yo u received reimbursements, fees, funding, or salary from an organization that  
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing int erests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
Reviewer Publication Consent. I agree for my report to be made available under an Open 
Access  Creative Commons CC -BY License ( http://creativecommons.org/licenses/by/4.0 ) if 
this manuscript  is accepted for publication. Any comments that I do not wish to be included 
in the published  report have been included as confidential comments to the editor, which will 
not be published.  If you are not happy for us to publish this report, please contact the editorial 
office before completing  the review.  If you wish, you ca n include your name in your 
published report. Please note you must  decide whether to include your name at the start of the 
process and confirm this decision whenever  prompted. If you change your decision later, we 
will not be able to publish your name.  
 
I agree to the terms of the CC -BY 4.0 license; please do not publish my name with my 
report.  
(default)  
 
 
 
 
 
 
Publons Reviewer Recognition . Springer Nature can send verification of this review directly 
to Publons (a subsidiary of Clarivate Analytics). If you would l ike to take advantage of this 
service,  please click on the “Yes” option below. Your name, email address, title of the 
reviewed  manuscript, name of the journal, and date of your review submission (the “Review 
Data”) will  then be transmitted to Publons upon publication of the manuscript. If you have 
already registered  at Publons, they will notify you of the receipt of this review and update 
your profile as per your  settings and their policy. If you are not registered with Publons, you 
will receive an email fr om them asking you to register in order for them to be able to 
recognize your review on your new  profile page. Publons may use the Review Data to 
generate derivative metadata for the benefit of  Publons and you as a reviewer, carefully 
considering the sensi tivity of such information. For  example, Publons may verify your record 
as a reviewer by updating your profile published on its  webservice if you have registered for 
such service or help editors to identify candidate reviewers.  Please find the details of 
processing in Publons ’ privacy policy https://publons.com/about/terms  
 
Yes 
assistant