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World Journal of Surgery

, Volume 38, Issue 7, pp 1843–1851 | Cite as

Effectiveness of a Transanal Tube for the Prevention of Anastomotic Leakage after Rectal Cancer Surgery

  • Hideaki Nishigori
  • Masaaki Ito
  • Yuji Nishizawa
  • Yusuke Nishizawa
  • Akihiro Kobayashi
  • Masanori Sugito
  • Norio Saito
Article

Abstract

Aim

We evaluated the effectiveness and safety of a transanal tube placed for the prevention of anastomotic leakage after rectal surgery.

Methods

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.

Results

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.

Conclusions

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.

Keywords

Anastomotic Leakage Anterior Resection Anal Verge Rectal Cancer Surgery Preoperative Chemoradiotherapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Conflict of interest

None.

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Copyright information

© Société Internationale de Chirurgie 2013

Authors and Affiliations

  • Hideaki Nishigori
    • 1
  • Masaaki Ito
    • 1
  • Yuji Nishizawa
    • 2
  • Yusuke Nishizawa
    • 1
  • Akihiro Kobayashi
    • 1
  • Masanori Sugito
    • 1
  • Norio Saito
    • 1
  1. 1.Colorectal and Pelvic Surgery Division, Department of Surgical OncologyNational Cancer Center Hospital EastKashiwaJapan
  2. 2.Department of Gastroenterological Surgery, Faculty of MedicineKagawa UniversityTakamatsuJapan

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