Use of a Transanal Drainage Tube for Prevention of Anastomotic Leakage and Bleeding after Anterior Resection for Rectal Cancer

Zhao, Wen-Tao; Hu, Fengliang; Li, Yuying; Li, Hongjie; Luo, Wei; Sun, Feng

doi:10.1007/s00268-012-1812-9

Cited by 82 publications

(90 citation statements)

References 55 publications

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“…It has been reported that a DS reduces symptomatic AL, and a DS should be fashioned in rectal cancer patients with anastomoses below 6 cm, particularly in men [23][24][25] . The findings of this study might differ from previous results because a transanal tube was placed, which has been found to reduce the rate of AL after Lap-LAR [15,20,[26][27][28] . However, AL still occurred in patients who had a transanal tube placed.…”

Section: Discussioncontrasting

confidence: 56%

Fecal Volume after Laparoscopic Low Anterior Resection Predicts Anastomotic Leakage

Hidaka

Maeda²,

Nakahara³

et al. 2017

Dig Surg

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Background/Aim: Anastomotic leakage (AL) is a major complication after laparoscopic low anterior resection (Lap-LAR). Many surgeons encounter AL following severe postoperative diarrhea. However, little is known about the relationship between postoperative fecal volume and AL. This study determined whether postoperative fecal volume can predict AL. Methods: A retrospective assessment was performed with data from 176 patients with rectal cancers who underwent Lap-LAR between April 2011 and August 2015. A transanal tube was routinely placed in all cases. The fecal volume from the transanal tube was measured daily. The total fecal volume for 3 days after surgery was compared between the AL and non-AL groups. Results: AL occurred in 11 patients. There were 3 patients with a fecal volume ≥1,000 mL for 3 days after surgery. AL occurred in these 3 patients. In patients with a fecal volume <1,000 mL, the total fecal volume was significantly greater in the AL group than that in the non-AL group (p = 0.0003). The cut-off value of the total fecal volume in AL was 118 mL. Conclusions: The volume of fecal discharge for 3 days after surgery is associated with the incidence of AL, and a fecal volume ≥118 mL may be a reliable predictor for AL.

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Section: Discussioncontrasting

confidence: 56%

Fecal Volume after Laparoscopic Low Anterior Resection Predicts Anastomotic Leakage

Hidaka

Maeda²,

Nakahara³

et al. 2017

Dig Surg

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“…However, after reading the titles and abstracts, 19 papers that did not conform to the entry criteria were excluded, as were four other papers after a review of the full text. After the exclusions, four studies were selected for inclusion in this meta-analysis [20,21,24,25]. A Consolidated Standards of Reporting Trials flow diagram is shown in Fig.…”

Section: Included Studiesmentioning

confidence: 99%

“…Xiao et al [24] used a soft silicone tube that was 12 cm in length and with several lateral apertures. Zhao et al [25] used a rubber drainage tube (26 Fr) and positioned it with the tip 3-5 cm proximal to the anastomotic site. Nishigori et al [21] used a Ficon tube (24 Fr) and placed the tip of a transanal tube approximately 3-5 cm from the oral side of the anastomosis.…”

Section: Surgical Proceduresmentioning

confidence: 99%

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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“…L. Xiao et al [38], применив методику transanal tube для защиты колоректального соустья, НА отметили у 7/188 (3,7%), а в группе без про-текции -у 17/182 (9,3%) пациентов (р=0,028). По данным W-T. Zhao et al [39], при той же методике НА после резекций ПК выявлена у 2/81 (2,5%), а в группе без ТАТ -у 7/77 (9,1%) пациентов (р=0,16). В сравнительно-ретроспек-тивных исследованиях H. Nishigori et al [40] и E. Hidaka et al [41] [42]).…”

Section: кишечные стомыunclassified

Protection of an Anastomosis in Rectal Cancer Surgery

Januskevics¹,

Januskevics²

2017

Novosti Khirurgii

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Несостоятельность анастомоза (НА) при низких и ультранизких резекциях прямой кишки составля-ет 1,8-24%, послеоперационная летальность, ассоциированная с НА, достигает порой 32%. Превентивная кишечная стома снижает частоту и тяжесть этих осложнений почти в 3 раза. Однако в дальнейшем воз-никают дополнительные компликации, связанные как с наличием стомы, так и с ее ликвидацией.Приведенный обзор литературы посвящен актуальности проблемы и анализу не только наложения кишечных протективных стом (ПС), но и других, альтернативных способов защиты сформированных ко-лоректальных и колоанальных анастомозов. Показано, что «условно» формируемые илео-колостомии, илеостома «призрак», дополнительные «послабляющие» швы и различные способы трансанальной деком-прессии достоверно в сравнении с ПС снижают частоту НА. Однако, несмотря на простоту выполнения данные методы не нашли еще широкого применения в колопроктологии, возможно, из-за консерватизма хирургов и ограниченного числа публикаций. При методиках протекции VIB-valtrac secured intracolonic bypass и C-seal из-за наличия специальных биофрагментированных устройств (кольца valtrac и C-seal па-кетик), технических особенностей выполнения, отсутствия рандомизированных исследований отмечена ограниченность их клинического использования. К сожалению, при анализе литературы не выявлено работ по сочетанному (комбинированному) применению различных способов защиты анастомоза в зависимости от конкретной операционной ситуации. Проведение в данном аспекте параллельных с ПС проспективных рандомизированных исследований позволило бы более обоснованно подходить как к показаниям выбора способов защиты анастомоза, так и к наложению превентивных кишечных стом. Ключевые слова: рак прямой кишки, низкая передняя резекция прямой кишки, несостоятельность швов, колопроктология, превентивная стома, осложнения стом, протекция анастомозаThe incidence of anastomotic leakage (AL) after low or ultralow rectal resections ranges between 1.8% and 24%, although, postoperative mortality associated with AL can reach up to 32%. Preventive enterostomy reduces rate and degree of surgical complications by almost three times. However, both stoma-related problems and following stoma closure disasters may occur later on.The given literature review explores the relevance of the topic. It does not analyze rectal diverting stomas only, but also other alternative ways to protect the anastomosis. It has been marked that ileostomy, colostomy, ghost ileostomy, additional reinforcement and transanal decompression methods reduce the incidence of AL and give similar results comparing to diverting stoma. The reason why these methods, despite being easy to perform, have not been widely adopted in coloproctology, might be conservatism of surgeons or relative lack of literature. The use of several protection methods (VIB-valtrac secured intracolonic bypass ş C-seal) is limited due to the peculiar properties of the bioconfigured devices, the technical features of the implementation, the absence of randomized controlled trials (RCT). Unf...

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Use of a Transanal Drainage Tube for Prevention of Anastomotic Leakage and Bleeding after Anterior Resection for Rectal Cancer

Cited by 82 publications

References 55 publications

Fecal Volume after Laparoscopic Low Anterior Resection Predicts Anastomotic Leakage

Fecal Volume after Laparoscopic Low Anterior Resection Predicts Anastomotic Leakage

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

Protection of an Anastomosis in Rectal Cancer Surgery

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