title: International consensus statement regarding the use of animal models for research on anastomoses in the lower gastrointestinal tract.
abstract: OBJECTIVE
  This project aimed to reach consensus on the most appropriate animal models and outcome measures in research on anastomoses in the lower gastrointestinal tract (GIT). The physiology of anastomotic healing remains an important research topic in gastrointestinal surgery. Recent results from experimental studies are limited with regard to comparability and clinical translation.
  
  
  METHODS
  PubMed and EMBASE were searched for experimental studies investigating anastomotic healing in the lower GIT published between January 1, 2000 and December 31, 2014 to assess currently used models. All corresponding authors were invited for a Delphi-based analysis that consisted of two online survey rounds followed by a final online recommendation survey to reach consensus on the discussed topics.
  
  
  RESULTS
  Two hundred seventy-seven original articles were retrieved and 167 articles were included in the systematic review. Mice, rats, rabbits, pigs, and dogs are currently being used as animal models, with a large variety in surgical techniques and outcome measures. Forty-four corresponding authors participated in the Delphi analysis. In the first two rounds, 39/44 and 35/39 participants completed the survey. In the final meeting, 35 experts reached consensus on 76/122 items in six categories. Mouse, rat, and pig are considered appropriate animal models; rabbit and dog should be abandoned in research regarding bowel anastomoses. ARRIVE guidelines should be followed more strictly.
  
  
  CONCLUSIONS
  Consensus was reached on several recommendations for the use of animal models and outcome measurements in research on anastomoses of the lower GIT. Future research should take these suggestions into account to facilitate comparison and clinical translation of results.
authors.affiliation: Department of General Surgery, Maastricht University Medical Centre, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands. ac.bosmans@maastrichtuniversity.nl.|NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands. ac.bosmans@maastrichtuniversity.nl.
authors.forename: Joanna W A M
authors.initials: JWAM
authors.lastname: Bosmans
authors.affiliation: Department of General Surgery, Maastricht University Medical Centre, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands.|GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands.
authors.forename: Martine
authors.initials: M
authors.lastname: Moossdorff
authors.affiliation: Department of General Surgery, Maastricht University Medical Centre, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands.
authors.forename: Mahdi
authors.initials: M
authors.lastname: Al-Taher
authors.affiliation: Department of General Surgery, Maastricht University Medical Centre, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands.
authors.forename: Lotte
authors.initials: L
authors.lastname: van Beek
authors.affiliation: NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.|Pediatric Surgical Center of Amsterdam, Emma Children's Hospital University Medical Centre and VU Medical Centre, Amsterdam, The Netherlands.
authors.forename: Joep P M
authors.initials: JPM
authors.lastname: Derikx
authors.affiliation: Department of General Surgery, Maastricht University Medical Centre, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands.|NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.
authors.forename: Nicole D
authors.initials: ND
authors.lastname: Bouvy
mesh_terms: D000714:Anastomosis, Surgical / Q000009:adverse effects; D000818:Animals; D035843:Biomedical Research; D032921:Consensus; D004195:Disease Models, Animal; D038622:Internationality; D041741:Lower Gastrointestinal Tract / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D011795:Surveys and Questionnaires
keywords: Anastomotic healing; Animal models; Colorectal anastomosis; Consensus; Experimental studies