TITLE:
Efficacy and Safety of Transanal Tube Drainage for Prevention of Anastomotic Leakage Following Laparoscopic Low Anterior Resection for Rectal Cancers
AUTHORS:
Yasutake Uchima, Naoki Aomatsu, Hironari Miyamoto, Takuma Okada, Shigeaki Kurihara, Toshiki Hirakawa, Takehiko Iwauchi, Junya Morimoto, Shigehito Yamagata, Kazunori Nakazawa, Kazuhiro Takeuchi
KEYWORDS:
Rectal Cancer, Anastomosis Leakage, Transanal Drainage Tube
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.9 No.7,
July
10,
2018
ABSTRACT: Introduction: Laparoscopic surgery is widely used for the treatment of colorectal
cancer. But anastomotic leakage is one of the most serious complications
following laparoscopic low anterior resection (LAR) for rectal cancer. The
purpose of this study was to investigate whether transanal drainage tube
placement can reduce anastomotic leakage and avoid re-operation after laparoscopic
LAR. Methods: Retrospective assessment was performed on 143 patients
with rectal cancers who underwent laparoscopic LAR between April 2009 and March
2016. A diverting stoma was not created in all 143 patients. A transanal
drainage tube was placed after anastomosis using a double stapling technique,
in 90 patients (group TT). In group TT, a 24 Fr. Silicon catheter was inserted
into the anus and was placed approximately 20 - 25 cm
in the descending colon. Another 53 patients were operated on without a
transanal drainage tube (group NTT). Clinicopathological and operative
variables, the frequencies of anastomotic leakage and re-operation after
leakage were investigated. Results: Between the two groups (Group TT and
NTT), age, gender, body mass index, tumor size, Dukes’ stage, the number of Liniar
stapler firings for rectal transaction, and the rate of left colic artery
preservation were comparable. Intra-operative blood loss and operation time
decreased group TT from group NTT (p = 0.07) and all cases with symptomatic leakage in group TT were cured by
conservative treatment. There was no side effect of transanal
drainage tube (perforation or bleeding of the colon, or deviation of the tube)
in Group TT. Conclusions: Transanal drainage tube placement prevents anastomotic leakage after laparoscopic LAR. We regard the transnanal drainage
tube to be safe and effective without side effect.