Effect comparison of three different types of transanal drainage tubes after anterior resection for rectal cancer

Abstract

Background: Anastomotic leakage (AL) is one of the most severe early complications after rectal cancer surgery. Many studies and meta-analysis results show that the indentation of transanal drainage tubes (TDT) can prevent and reduce the incidence of AL. However, the size and material of drainage tubes are rarely reported. Herein, we compare the effect of three kinds of TDT and analyze the use of TDT material and size to prevent AL, which may better prevent the occurrence of AL. Methods: The clinical data of 182 patients who underwent laparoscopic anterior resection of rectal cancer were retrospectively analyzed between January 2016 and March 2019. According to the types of indwelling TDT after the operation, they were divided into Fr32 silicone tubes (81 cases), Fr24 silicone tubes (54 cases), Fr24 latex tubes (47 cases). The first drainage, exhaust, defecation, abdominal distension and anastomotic leakage of the patients with three different types of TDT were compared. Results: There was no significant difference in the degree of first exhaust, abdominal distension and anastomotic leakage among three different types of TDT; the time of first drainage and defecation of the Fr32 silicone tube was significantly earlier than that of Fr24 silicone tube and Fr24 latex tube. Conclusion: The drainage effect of the Fr32 silicone tube is better than that of Fr24 silicone tube and Fr24 latex tube after anterior resection for rectal cancer, Fr32 silicone may better prevent the occurrence of AL, but randomized controlled studies are needed.

Colon perforation caused by transanal decompression tube after laparoscopic low anterior resection: A case report

“…TDTs are now widely used to prevent anastomotic leakage after rectal surgery [ [1] , [2] , [3] , [4] , [5] , [6] , [7] ]. It was reported that the TDT presented non-inferiority in preventing anastomotic leakage, less operation time and blood loss, no difference in early postoperative complications and less incidence in late complication compared to the ileostomy [ 11 ].…”

“…The kind of tube, size, material, site and length of placement and duration are still controversial. In most studies, a silicon rubber tube was used [ [1] , [2] , [3] , [4] , 7 ], and the tube size ranged from 24 to 32 Fr (about 8−10 mm) [ 1 , 3 , 4 , 7 ]. Luo et al compared different types of TDT, such as a 32-Fr silicone tube, 24-Fr silicone tube and 24-Fr latex tube [ 7 ].…”

“…In most studies, a silicon rubber tube was used [ [1] , [2] , [3] , [4] , 7 ], and the tube size ranged from 24 to 32 Fr (about 8−10 mm) [ 1 , 3 , 4 , 7 ]. Luo et al compared different types of TDT, such as a 32-Fr silicone tube, 24-Fr silicone tube and 24-Fr latex tube [ 7 ]. Although no significant difference was noted in the occurrence of anastomotic leakage among the different tubes (1.23% with the 32-Fr silicone tube, 5.56% with the 24-Fr silicone tube, 6.38% with the 24-Fr latex tube), the 32-Fr silicon tube showed a significantly earlier time of first drainage and defecation than the other types [ 7 ].…”

“…Anastomotic leakage after rectal surgery is a serious complication, with a recently reported incidence of 3.9–13.1% [ [1] , [2] , [3] , [4] , [5] , [6] , [7] ]. To prevent anastomotic leakage, various attempts have recently been performed during surgery, such as the usage of a transanal decompression tube (TDT), the application of a polyglycolic acid sheet to reinforce staple lines of the rectal stump and/or the use of a powered circular stapler [ [4] , [5] , [6] , [7] , [8] , [9] ].…”

“…In particular, many studies have described the effectiveness of a TDT for preventing anastomotic leakage, and it has become widely accepted in recent years [ [1] , [2] , [3] , [4] , [5] , 7 ]. However, the type of TDT to be used as well as its proper position and duration of placement are controversial.…”