International consensus statement regarding the use of animal models for research on anastomoses in the lower gastrointestinal tract

Joanna W. A. M. Bosmans*, Martine Moossdorff, Mahdi Al-Taher, Lotte van Beek, Joep P. M. Derikx, Nicole D. Bouvy

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


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. 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. 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. 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.
Original languageEnglish
Pages (from-to)1021-1030
Number of pages10
JournalInternational Journal of Colorectal Disease
Issue number5
Publication statusPublished - May 2016


  • Anastomotic healing
  • Consensus
  • Animal models
  • Experimental studies
  • Colorectal anastomosis

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