Use of a transanal drainage tube for prevention of anastomotic leakage and bleeding after anterior resection for rectal cancer.
BACKGROUND
The aim of the present study was to investigate the usefulness of the transanal drainage tube for prevention of anastomotic leakage and bleeding after anterior resection for rectal cancer.


METHODS
Between January 2007 and May 2011 a nonrandomized prospective study of patients undergoing anterior resection for rectal cancer was done. The patients were divided into the transanal drainage tube (TDT) and non-transanal drainage tube (NTDT) groups according to whether the transanal drainage tube was used in the operation. Clinical characteristics and postoperative complications were compared between the TDT and NTDT groups.


RESULTS
The study included 81 patients in the TDT group and 77 patients in the NTDT group. In the TDT group, anastomotic leakage occurred in 2 patients and no anastomotic bleeding occurred. In the NTDT group, anastomotic leakage occurred in 7 patients and anastomotic bleeding occurred in 2 patients. The TDT group had significantly fewer anastomotic complications compared with the NTDT group (2.5 vs 11.7 %; P = 0.029). Furthermore, the TDT group showed an obvious reduction in the rate of anastomotic leakage and anastomotic bleeding compared with the NTDT group (2.5 vs 7.8 % and 0.0 vs 2.6 %), but because the number of cases is relatively small, the difference did not reach statistical significance (P = 0.160 and P = 0.236).


CONCLUSIONS
The use of a transanal drainage tube in anterior resection for rectal cancer may be a simple, safe, and effective means of preventing or reducing the occurrence of anastomotic leakage and bleeding. A larger-scale single or multi-center prospective randomized study or a meta-analysis including similar studies is necessary for further elucidation of this issue.
Department of Colorectal Surgery, The First Affiliated Hospital, Guangzhou University of Traditional Chinese Medicine, Guangzhou, People's Republic of China. zhao_wen_tao@tom.com
Wen-Tao
WT
Zhao
Feng-Liang
FL
Hu
Yu-Ying
YY
Li
Hong-Jie
HJ
Li
Wei-Ming
WM
Luo
Feng
F
Sun
D000368:Aged; D001003:Anal Canal; D057868:Anastomotic Leak / Q000517:prevention & control*; D013505:Digestive System Surgical Procedures / Q000379:methods; D004322:Drainage / Q000379:methods*; D005260:Female; D006470:Hemorrhage / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000601:surgery*