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

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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.

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Authors and Affiliations

  1. Colorectal and Pelvic Surgery Division, Department of Surgical Oncology, National Cancer Center Hospital East, Kashiwanoha 6-5-1, Kashiwa, Chiba, 277-8577, Japan

    Hideaki Nishigori, Masaaki Ito, Yusuke Nishizawa, Akihiro Kobayashi, Masanori Sugito & Norio Saito

  2. Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Takamatsu, Japan

    Yuji Nishizawa

Authors
  1. Hideaki Nishigori
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  2. Masaaki Ito
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  3. Yuji Nishizawa
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  4. Yusuke Nishizawa
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  5. Akihiro Kobayashi
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  6. Masanori Sugito
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  7. Norio Saito
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Correspondence to Masaaki Ito.

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Nishigori, H., Ito, M., Nishizawa, Y. et al. Effectiveness of a Transanal Tube for the Prevention of Anastomotic Leakage after Rectal Cancer Surgery. World J Surg 38, 1843–1851 (2014). https://doi.org/10.1007/s00268-013-2428-4

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