Soo Young Lee1, Chang Hyun Kim1, Young Jin Kim1, Hyeong Rok Kim2. 1. Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro Hwasun-eup, Hwasun-gun Jeonnam, 519-763, Korea. 2. Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro Hwasun-eup, Hwasun-gun Jeonnam, 519-763, Korea. drkhr@chonnam.ac.kr.
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.
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 cancerpatients 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.
Authors: K C M J Peeters; R A E M Tollenaar; C A M Marijnen; E Klein Kranenbarg; W H Steup; T Wiggers; H J Rutten; C J H van de Velde Journal: Br J Surg Date: 2005-02 Impact factor: 6.939
Authors: Thierry Bege; Bernard Lelong; Benjamin Esterni; Olivier Turrini; Jerôme Guiramand; Daniel Francon; Djamel Mokart; Gilles Houvenaeghel; Marc Giovannini; Jean Robert Delpero Journal: Ann Surg Date: 2010-02 Impact factor: 12.969