Transanal Tube Drainage as a Conservative Treatment for Anastomotic Leakage Following a Rectal Resection

Shalaby, Mostafa; Thabet, Waleed; Buonomo, Oreste Claudio; Lorenzo, Nicola Di; Morshed, Mosaad; Petrella, Giuseppe; Farid, Mohamed; Sileri, Pierpaolo

doi:10.3393/ac.2017.10.18

Cited by 14 publications

(12 citation statements)

References 31 publications

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“…Transanal drainage has been associated with successful healing and subsequent stoma closure rate of over 90% in selected patients [7, 8]. The transanal endoscopic vacuum-assisted closure system (EVAC) was introduced in the beginning of the 2000s and aims to achieve continuous drainage and promote granulation in the anastomotic leakage cavity.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Results after Anastomotic Leakage following Rectal Cancer Surgery: A Comparison of Treatment with Endo-Sponge and Transanal Irrigation

et al. 2020

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We aimed to evaluate long-term results in patients from regular health care treated with endoscopic transanal closure system, that is, endoscopic vacuum-assisted closure system (EVAC) compared to transanal irrigation. Methods: In this retrospective, medical chart-based, observational study, we included patients with anastomotic leakage after low anterior resection for rectal cancer from 3 Stockholm hospitals 2006-2016 and compared time to first stoma closure in a Kaplan-Meier model and the proportion of patients who were stoma-free at end of follow-up. Results: Anastomotic leakage was found in 81 patients who were followed up in median 5.9 years (min-max: 0.53-13). EVAC was used on 14 (17%) patients and transanal irrigation on 34 (42%) patients. The remaining 33 (41%) patients either got a permanent colostomy or were treated only with antibiotics and percutaneous drainage. Treatment with EVAC or transanal irrigation led to similar rates of stoma closure, both when comparing all patients, and when comparing patients with similar defects. At the end of follow-up, 43% of patients treated with EVAC and 50% of patients treated with repeated irrigation were stoma-free (p = 0.75). Conclusions: We found no evidence of better outcomes in patients treated with EVAC. The study was, however, limited by small sample size.

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Section: Introductionmentioning

confidence: 99%

Long-Term Results after Anastomotic Leakage following Rectal Cancer Surgery: A Comparison of Treatment with Endo-Sponge and Transanal Irrigation

et al. 2020

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“…Therefore, TDT can prevent and reduce rectal AL. However, we find that the size and material of the drainage tube are rarely reported in literature [24][25][26].…”

Section: Discussionmentioning

confidence: 70%

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

Luo

Zhu

et al. 2020

BMC Surg

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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.

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“…Recently, many systematic reviews and meta-analyses have consistently reported that TAT significantly lowers AL compared with not using it [7,8,15]. It was also reported that TAT could be effective in treatment when AL occurred [16]. However, there have been few studies addressing whether TAT has protective effect similar to DS by direct comparison.…”

Section: Discussionmentioning

confidence: 99%

The usefulness of transanal tube for reducing anastomotic leak in mid rectal cancer: compared to diverting stoma

Cho

Lee

et al. 2021

Ann Surg Treat Res

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Anastomotic leak (AL) is defined as communication between intra-and extraluminal compartments caused by a defect in intestinal wall integrity at the anastomosis [1]. AL after colorectal surgery is one of the most dreadful complications because it can cause septic complications due to intraabdominal contamination from fecal content and may require reoperation often followed by creating a stoma [2,3]. In addition, AL after cancer surgery is known to increase locoregional recurrence and decrease survival rate [4,5].Despite the development of novel surgical techniques and instruments, the incidence rate of AL has not declined in recent decades [6]. According to previous research that analyzed the results of rectal cancer surgeries from 1990 to 2008 in 84 prospective cohort studies, the AL rate was approximately 11% and remains considerably high [2]. Therefore, studies aimed at reducing AL are of ongoing interest, and the 2 most common

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Transanal Tube Drainage as a Conservative Treatment for Anastomotic Leakage Following a Rectal Resection

Cited by 14 publications

References 31 publications

Long-Term Results after Anastomotic Leakage following Rectal Cancer Surgery: A Comparison of Treatment with Endo-Sponge and Transanal Irrigation

Long-Term Results after Anastomotic Leakage following Rectal Cancer Surgery: A Comparison of Treatment with Endo-Sponge and Transanal Irrigation

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

The usefulness of transanal tube for reducing anastomotic leak in mid rectal cancer: compared to diverting stoma

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