Title: Risk assessment of rectal anastomotic leakage (RAREAL) after DIXON in non-
emergency patients with rectal cancer: a retrospective study
Version: 4 Date: 02 May 2023
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research
question(s) (brief or other article types: is there a clear objective)?
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
No - there are major issues
EXECUTION - Are the experiments and analyses performed with technical rigor to allow
confidence in the results?
No - there are minor issues
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
Yes - the author's interpretation is reasonable
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically
sound? If not, can revisions be made to make the work technically sound?
Maybe - with major revisions
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: The authors report a retrospective analysis of patients with rectal
surgery. Its main strength is the sample size and the level of details available.
There is one fundamental issue I see - the authors have included patients with and without a
defunctioning stoma in the analysis. The post-operative course of these two groups are different.
Even though both development and validation groups contained similar proportions, I feel this
is methodologically flawed.
REQUESTED REVISIONS:
The main issue is in including patients with and without stoma together, and I have explained
this above.
Table 1 states most patients (nearly 80%) did not have a malignancy. The title states this is a
study on rectal cancer patients. Can you please clarify?
Was ICG or other technique used to assess perfusion? Since one finding of the study relates to
perfusion, this must be included in the discussion.
The majority of leaks had a score of 5, no leaks were seen for the score of 4. Can you explain this?
The style of writing needs improvement - e.g., "intestinal pollution"
Title: Risk assessment of rectal anastomotic leakage (RAREAL) after DIXON in non-
emergency patients with rectal cancer: a retrospective study
Version: 4 Date: 02 May 2023
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research
question(s) (brief or other article types: is there a clear objective)?
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
No - there are major issues
EXECUTION - Are the experiments and analyses performed with technical rigor to allow
confidence in the results?
No - there are minor issues
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
Yes - the author's interpretation is reasonable
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically
sound? If not, can revisions be made to make the work technically sound?
Maybe - with major revisions
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: The authors report a retrospective analysis of patients with rectal
surgery. Its main strength is the sample size and the level of details available.
There is one fundamental issue I see - the authors have included patients with and without a
defunctioning stoma in the analysis. The post-operative course of these two groups are different.
Even though both development and validation groups contained similar proportions, I feel this
is methodologically flawed.
REQUESTED REVISIONS:
The main issue is in including patients with and without stoma together, and I have explained
this above.
Table 1 states most patients (nearly 80%) did not have a malignancy. The title states this is a
study on rectal cancer patients. Can you please clarify?
Was ICG or other technique used to assess perfusion? Since one finding of the study relates to
perfusion, this must be included in the discussion.
The majority of leaks had a score of 5, no leaks were seen for the score of 4. Can you explain this?
The style of writing needs improvement - e.g., "intestinal pollution"
Please review this paper.
user
Title: Risk assessment of rectal anastomotic leakage (RAREAL) after DIXON in non-
emergency patients with rectal cancer: a retrospective study
Version: 4 Date: 02 May 2023
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research
question(s) (brief or other article types: is there a clear objective)?
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
No - there are major issues
EXECUTION - Are the experiments and analyses performed with technical rigor to allow
confidence in the results?
No - there are minor issues
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
Yes - the author's interpretation is reasonable
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically
sound? If not, can revisions be made to make the work technically sound?
Maybe - with major revisions
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: The authors report a retrospective analysis of patients with rectal
surgery. Its main strength is the sample size and the level of details available.
There is one fundamental issue I see - the authors have included patients with and without a
defunctioning stoma in the analysis. The post-operative course of these two groups are different.
Even though both development and validation groups contained similar proportions, I feel this
is methodologically flawed.
REQUESTED REVISIONS:
The main issue is in including patients with and without stoma together, and I have explained
this above.
Table 1 states most patients (nearly 80%) did not have a malignancy. The title states this is a
study on rectal cancer patients. Can you please clarify?
Was ICG or other technique used to assess perfusion? Since one finding of the study relates to
perfusion, this must be included in the discussion.
The majority of leaks had a score of 5, no leaks were seen for the score of 4. Can you explain this?
The style of writing needs improvement - e.g., "intestinal pollution"
assistant