Efficacy of transanal drainage for anastomotic leakage after laparoscopic low anterior resection of the rectum

Okoshi, Kae; Masano, Yuuki; Hasegawa, Suguru; Hida, Koya; Kawada, Kenji; Nomura, Akihiro; Kawamura, Junichiro; Nagayama, Satoshi; Yoshimura, Tsunehiro; Sakai, Yoshiharu

doi:10.1111/ases.12010

Cited by 19 publications

(17 citation statements)

References 22 publications

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“…Recent studies have reported that TDT was effective for localizing leakage, controlling sepsis, and reducing the diverting stoma rate after a low anterior resection of the rectum [38,39]. From these results, we hypothesized that TDT placement can drain stool and gas from the rectum; therefore, the stool cannot spread out from the anastomotic fistula to the pelvic space and result in a localized peritonitis.…”

Section: Discussionmentioning

confidence: 94%

A meta-analysis of the use of a transanal drainage tube to prevent anastomotic leakage after anterior resection by double-stapling technique for rectal cancer

et al. 2015

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Section: Discussionmentioning

confidence: 94%

A meta-analysis of the use of a transanal drainage tube to prevent anastomotic leakage after anterior resection by double-stapling technique for rectal cancer

et al. 2015

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“…Sirois-Giguere et al [29] managed 43% of ALs after anterior resection with trans-anal drainage techniques. Okoshi et al [30] conservatively treated 12 patients with trans-anal drainage, with 83% being successfully being treated with this approach. Endoscopic insertion of a vacuum sponge (EndoSPONGE TM ) has been proposed as an alternative to radiological drainage, with excellent healing rates reported [31,32].…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive approaches to the management of anastomotic leakage following restorative rectal cancer resection

et al. 2019

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Aim Management of anastomotic leakage (AL) following rectal resection has evolved with increasing use of less invasive techniques. The aim of this study was to review the management of AL following restorative rectal cancer resection in a tertiary referral centre. Method A retrospective review of a prospectively maintained database was performed. The primary outcome was successful management of AL. The secondary outcome was the impact of AL on oncological outcome. Results Five hundred and two restorative rectal cancer resections were performed during the study period. The incidence of AL was 9.9% (n = 50). AL occurred more commonly following neoadjuvant chemoradiotherapy (n = 31/252, 12.3%) than in those who did not receive neoadjuvant chemoradiotherapy (n = 19/250, 7.6%; P = 0.107); however, this was not statistically significant. Successful minimally invasive drainage was achieved in 28 patients (56%, radiological n = 24, surgical n = 4). Trans‐rectal drainage was the most common drainage method (n = 14). The median duration of drainage was longer in the neoadjuvant group (27 vs 18 days). Surgical intervention was required in 11 patients, with anastomotic takedown and end‐colostomy formation was most commonly required. Successful management of AL with drainage (maintenance of the anastomosis without the need for further intervention) was achieved in 26 of the 28 patients. There were no significant differences in overall or disease‐free survival when patients with AL were compared with patients without AL (69.4% vs 72.6%, P = 0.99 and 78.7% vs 71.3%, P = 0.45, respectively). Conclusion In selected patients, AL following restorative rectal resection can be effectively controlled using minimally invasive radiological or surgical drainage without the need for further intervention.

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“…TDT can also be useful to cure localized peritonitis related to AL. Several reports have stated that the TDT is effective for localizing AL and controlling sepsis following LAR [100,101] . Shrinkage of an abscess by a TDT inserted into the cavity can localize inflammation, which results in a reduced incidence of reoperation.…”

Section: Transanal Drainage Tubementioning

confidence: 99%

Preoperative, intraoperative and postoperative risk factors for anastomotic leakage after laparoscopic low anterior resection with double stapling technique anastomosis

Kawada

Sakai

2016

WJG

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104

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Anastomotic leakage (AL) is one of the most devastating complications after rectal cancer surgery. The double stapling technique has greatly facilitated intestinal reconstruction especially for anastomosis after low anterior resection (LAR). Risk factor analyses for AL after open LAR have been widely reported. However, a few studies have analyzed the risk factors for AL after laparoscopic LAR. Laparoscopic rectal surgery provides an excellent operative field in a narrow pelvic space, and enables total mesorectal excision surgery and preservation of the autonomic nervous system with greater precision. However, rectal transection using a laparoscopic linear stapler is relatively difficult compared with open surgery because of the width and limited performance of the linear stapler. Moreover, laparoscopic LAR exhibits a different postoperative course compared with open LAR, which suggests that the risk factors for AL after laparoscopic LAR may also differ from those after open LAR. In this review, we will discuss the risk factors for AL after laparoscopic LAR.

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Efficacy of transanal drainage for anastomotic leakage after laparoscopic low anterior resection of the rectum

Abstract: Transanal drainage may be a viable option for the treatment of anastomotic leakage after low anterior resection of the rectum.

Cited by 19 publications

References 22 publications

A meta-analysis of the use of a transanal drainage tube to prevent anastomotic leakage after anterior resection by double-stapling technique for rectal cancer

A meta-analysis of the use of a transanal drainage tube to prevent anastomotic leakage after anterior resection by double-stapling technique for rectal cancer

Minimally invasive approaches to the management of anastomotic leakage following restorative rectal cancer resection

Preoperative, intraoperative and postoperative risk factors for anastomotic leakage after laparoscopic low anterior resection with double stapling technique anastomosis

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