Effectiveness of a Transanal Tube for the Prevention of Anastomotic Leakage after Rectal Cancer Surgery
- 697 Downloads
We evaluated the effectiveness and safety of a transanal tube placed for the prevention of anastomotic leakage after rectal surgery.
Between 2007 and 2011, a total of 243 patients underwent anterior resection using the double stapling technique for rectal cancer at our institution. We excluded 67 patients with diverting stoma and divided the remaining patients into two groups: patients who did not receive a transanal tube and diverting stoma (n = 140; control group) and those who received a transanal tube (n = 36). We compared the rate of anastomotic leakage, evaluated the complications associated with the transanal tube, and analyzed the risk factors for anastomotic leakage.
The following perioperative parameters were significantly different between the two groups as follows (control group vs. transanal tube group): diabetes mellitus (8 [22 %] vs. 12 [8.5 %] patients, respectively; p = 0.03), surgical duration (262 ± 54.1 min [171–457] vs. 233 ± 61.7 min [126–430], respectively; p < 0.01). The postoperative anastomosis leakage appeared significantly different between the two groups (1 [2.7 %] vs. 22 [15.7 %] patients, respectively; p = 0.04). Anastomotic leakage was significantly associated with the distance between the anastomosis line and the anal verge (odds ratio [OR] 8.58; 95 % confidence interval [CI] 1.53–48.0; p = 0.01) and non-use of a transanal tube (OR 11.1; 95 % CI 1.04–118; p = 0.04) in both univariate and multivariate analyses.
Placement of a transanal tube is effective in decreasing the rate of anastomotic leakage after anterior resection using the double stapling technique. However, complications associated with a transanal tube should be carefully considered.
KeywordsAnastomotic Leakage Anterior Resection Anal Verge Rectal Cancer Surgery Preoperative Chemoradiotherapy
Conflict of interest
- 19.Kim NK, Baik SH, Seong JS et al (2006) Oncologic outcomes after neoadjuvant chemoradiation followed by curative resection with tumor-specific mesorectal excision for fixed locally advanced rectal cancer: impact of postirradiated pathologic downstaging on local recurrence and survival. Ann Surg 244(6):1024–1030PubMedCentralPubMedCrossRefGoogle Scholar
- 26.Sobin L, Gospodarowicz M, Wittekind C (eds) (2009) UICC International union against cancer. TMN classification of malignant tumours, 7th edn. Wiley-Blackwell, HobokenGoogle Scholar
- 27.Japanese Society for Cancer of the Colon and Rectum (JSCCR) (2013) Japanese Classification of Colorectal Carcinoma, 8th edn.Google Scholar
- 29.Patrascu T, Doran H, Musat O (2004) Protective transanal tube in colo-rectal anastomosis. Chirurgia (Bucur) 99(1):75–78Google Scholar