Effect of placing double-lumen irrigation-suction tube on closure of anastomotic defect following rectal cancer surgery

Yao, Zheng; Tian, Weiliang; Huang, Ming; Xu, Xin; Zhao, Risheng

doi:10.1007/s00464-022-09523-0

Cited by 2 publications

(2 citation statements)

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“…These physiological effects might produce a negative influence on the wound healing of the duodenum. As local abundant blood supply is required to provide nutrients for the wound tissue, so as to promote the anastomosis to heal smoothly, while the anastomotic blood supply would directly lead to postoperative gastrointestinal fistula [15,26]. From this perspective, somatostatin may instead aggravate the occurrence of recurrent fistula after definitive surgery for DF.…”

Section: Discussionmentioning

confidence: 99%

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Effect of postoperative utilization of somatostatin on clinical outcome after definitive surgery for duodenal fistula

et al. 2023

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Purpose To evaluate the effect of postoperative utilization of somatostatin after definitive surgery for duodenal fistula (DF) in preventing a recurrence. Methods Patients with definitive surgery for DF between January 2010 and December 2021 were categorized based on the utilization of somatostatin or not after the surgery. Patients in the Somatostatin group were matched to those in the Non-somatostatin group using propensity scores matching (PSM), so as to evaluate the effect of postoperative use of somatostatin by comparing the two groups. Results A total of 154 patients were divided into the in the Somatostatin group (84) and the Non-somatostatin group (70). Forty-three patients (27.9%) exhibited a recurrent fistula, with which the postoperative use of somatostatin was not associated (19 [22.6%] in the Somatostatin group and 24 (34.3%) in the Non-somatostatin group; unadjusted OR 0.56; 95% CI 0.28–1.14; P = 0.11). However, the postoperative usage of somatostatin served as a protective factor for developing into high-output recurrent fistula (eight (13.3%) in the Somatostatin group and 15 (25%) in the Non-somatostatin group; adjusted OR 0.39; 95% CI 0.15–0.93; P = 0.04). After PSM, the recurrent fistula occurred in 29.2% subjects (35/120). The postoperative usage of somatostatin was not associated with recurrent fistula (13 in PSM Somatostatin group vs. 22 in PSM Non-somatostatin group; unadjusted OR 0.48; 95% CI 0.21–1.07; P = 0.07), while its postoperative usage decreased the incidence of recurrent high-output fistula (5/60 in the PSM Somatostatin group, compared with 13/60 in the PSM Non-somatostatin group; adjusted OR 0.30; 95% CI 0.09–0.95). Conclusion Postoperative use of somatostatin could effectively reduce the incidence of recurrent high-output fistula, without association with overall incidence of postoperative recurrent fistula.

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Section: Discussionmentioning

confidence: 99%

“…The proximal end was anastomosed with the small intestine at 40 cm from the duodenal-jejunal anastomosis. A double-lumen irrigation-suction tube [15] was placed near the duodenal-jejunal anastomosis, in case of postoperative recurrent fistula to achieve postoperative irrigation and drainage.…”

Section: Surgical Strategymentioning

confidence: 99%