28 Chapter 2 Search and Information Sources A literature search was performed on November 4, 2022 in the PubMed, Embase, and the Cochrane Library Database using MeSH-, Emtree-, and free terms (Supplementary 1). Reference lists of all publications were searched for additional studies. The cross-referencing method was continued until no further relevant publications were identified. Selection Process Inclusion and exclusion criteria Randomized controlled trials (RCTs), systematic reviews (SRs), and meta-analyses (Mas) containing data related to adult (>18 years) patients with CRC and in which AL was a primary or secondary outcome, were considered eligible. Studies published before 2000 (date of the first systematic review concerning AL definitions), other publication types and articles not in English or Dutch were excluded. Articles were excluded if AL was not a primary or secondary outcome as stated in the methods section, no AL definitions were stated in the study, or patients were not undergoing oncological procedures. Study selection All search results were imported into a web tool designed for SRs (Rayyan) 16. Firstly, all duplicates were removed. Secondly, the screening of studies for eligibility was independently performed by 2 reviewers (DH, OM), using the predefined in- and exclusion criteria in two phases. In the first phase, articles were screened based on title and abstract. Disagreements between reviewers were resolved by initial discussion to create consensus and/or by one of the senior authors (NB). As part of the second phase, full texts were assessed. If the eligibility criteria were met after full-text screening by both reviewers, article inclusion followed. All references were stored in the Endnote Reference Management Tool. Data Items and Collection Process Two reviewers (DH, OM) independently extracted data from text, tables, and figures in a standardized, predefined datasheet. Data extraction for each article included first author, year of publication, country, study design, number of patients, number of studies in case of a SR or MA, study aims, surgical details, definitions or criteria used for AL assessment (clinical, biochemical, radiologic criteria and/or finding during reoperation), all definitions of AL, clinical symptoms associated with definitions of AL, radiological modalities and findings used in the diagnosis of AL, findings at reoperation for AL, as well as grading terminology or classifications for AL. We ensured definitions and reporting elements were not doublecounted by cross-referencing RCTs included in systematic reviews. When systematic reviews provided their own AL definitions without detailing those from included studies, we treated these as separate entries. This method maintained data integrity. Data acquired through the outlined search strategy was summarized in tables.
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