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Impact of anal decompression on anastomotic leakage after low anterior resection for rectal cancer: a propensity score matching analysis

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Abstract

Purpose

The effectiveness of a transanal drainage tube for the prevention of anastomotic leakage (AL) is still uncertain. This study aimed to investigate the impact of anal decompression on AL after rectal cancer surgery.

Methods

We retrospectively reviewed 536 rectal cancer patients who underwent low anterior resection without diverting stoma, with (n = 154) or without (n = 382) placing of a transanal drainage tube, between January 2005 and December 2014. Risk factors for AL were analyzed, and propensity score matching analysis was used to compensate for the differences in baseline characteristics.

Results

AL occurred in 50 (9.3 %) of the patients. Male sex (odds ratio [OR] 3.097, p = 0.005), high ASA score (OR 3.505, p = 0.025), and neoadjuvant chemoradiation (OR 2.506, p = 0.018) were independent predictors of AL on multivariable analysis. After propensity score matching, transanal drainage tube tended to lessen rates of grade C AL with definite peritonitis (1.9 vs. 5.8 %, p = 0.077), although there was no difference in the incidence of AL in patients with or without transanal drainage tubes (5.8 vs. 9.1 %, p = 0.278).

Conclusions

Placement of a transanal drainage tube was not associated with a reduction in the total incidence of AL after low anterior resection for rectal cancer.

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Conflicts of interest

The authors received no financial support for this study. The authors declare no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was exempted because this retrospective study was harmless to the patients and contained no personal data. It was approved by the institutional review board of our institution.

Authors’ contributions

H.R.K. was responsible for the study conception and design. S.Y.L. and C.H.K. contributed to the acquisition of data; S.Y.L., C.H.K., and Y.J.K. to the analysis and interpretation of data; and S.Y.L. and H.R.K. to the drafting of the manuscript. Y.J.K. and H.R.K. were responsible for the critical revision of manuscript.

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Authors and Affiliations

  1. Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro Hwasun-eup, Hwasun-gun Jeonnam, 519-763, Korea

    Soo Young Lee, Chang Hyun Kim, Young Jin Kim & Hyeong Rok Kim

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  1. Soo Young Lee
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  2. Chang Hyun Kim
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  3. Young Jin Kim
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Correspondence to Hyeong Rok Kim.

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Lee, S.Y., Kim, C.H., Kim, Y.J. et al. Impact of anal decompression on anastomotic leakage after low anterior resection for rectal cancer: a propensity score matching analysis. Langenbecks Arch Surg 400, 791–796 (2015). https://doi.org/10.1007/s00423-015-1336-5

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  • DOI: https://doi.org/10.1007/s00423-015-1336-5

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