Usefulness of transanal tube placement for prevention of anastomotic leakage following laparoscopic low anterior resection

Ito, Tetsuo; Obama, Kazutaka; Sato, Teruyuki; Matsuo, Koichi; Inoue, Hirokazu; Kubota, Keiko; Tamaki, Nobuharu; Kami, Katsuya; Yoshimura, Naoki; Shono, Takahito; Yamamoto, Eiji; Morimoto, Tetsuya

doi:10.1111/ases.12310

Cited by 40 publications

(38 citation statements)

References 17 publications

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“…Only one case (2.3%) was found to occur AL in this study. It was almost the same rate of the previous report of Dr. Sato [9] and was better than the report of Dr. Ito [6].…”

Section: Discussionsupporting

confidence: 78%

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Anastomotic leakage rate following modified double staple technique of anterior resection with vertical division of the rectum for rectal cancer surgery

Tsubaki¹,

Suzuki²,

Adachi³

et al. 2017

Gastroenterol Hepatol Endosc

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“…Only one case (2.3%) was found to occur AL in this study. It was almost the same rate of the previous report of Dr. Sato [9] and was better than the report of Dr. Ito [6].…”

Section: Discussionsupporting

confidence: 78%

“…Recently, after Laparoscopic Low Anterior Resection (LLAR) AL occurred 12.3% among 154 patients [5]. To prevent AL after LLAR, Tetsuo Ito reported the usefulness of transanal tube [6]. They reported that AL rate was 3.6% in 28 patients with tube in comparison with 24.4% without tube replacement.…”

Section: Discussionmentioning

confidence: 99%

Anastomotic leakage rate following modified double staple technique of anterior resection with vertical division of the rectum for rectal cancer surgery

Tsubaki¹,

Suzuki²,

Adachi³

et al. 2017

Gastroenterol Hepatol Endosc

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“…Post-operative diarrhea: Ito et al[ 44 ] reported an association between postoperative diarrhea and occurrence of AL, with an OR of 86.3. The authors speculated that early postoperative diarrhea increases endoluminal pressure at the anastomotic site.…”

Section: Risk Factors For Leakagementioning

confidence: 99%

“…Diverting stoma: Although evidence regarding the clinical benefit of fecal diversion is conflicting, it is generally agreed that creation of a diverting stoma (DS) can reduce the clinically adverse effects of AL, including fecal peritonitis and septicemia, rather than preventing leakage. In a retrospective series of 69 patients undergoing LAR[ 44 ], no significant difference between DS group and no-DS group in terms of AL incidence (15.4% vs 16.3%) was noted. Although AL was observed in four patients in the DS group, none of them developed AL grade C. In contrast, 57.1% (4/7 cases) of the patients in the no-DS group developed AL grade C, but this difference did not reach statistical significance[ 44 ].…”

Section: Risk Factors For Leakagementioning

confidence: 99%

Predictive factors for anastomotic leakage after laparoscopic colorectal surgery

Sciuto

Merola²,

Palma

et al. 2018

WJG

254

181

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Every colorectal surgeon during his or her career is faced with anastomotic leakage (AL); one of the most dreaded complications following any type of gastrointestinal anastomosis due to increased risk of morbidity, mortality, overall impact on functional and oncologic outcome and drainage on hospital resources. In order to understand and give an overview of the AL risk factors in laparoscopic colorectal surgery, we carried out a careful review of the existing literature on this topic and found several different definitions of AL which leads us to believe that the lack of a consensual, standard definition can partly explain the considerable variations in reported rates of AL in clinical studies. Colorectal leak rates have been found to vary depending on the anatomic location of the anastomosis with reported incidence rates ranging from 0 to 20%, while the laparoscopic approach to colorectal resections has not yet been associated with a significant reduction in AL incidence. As well, numerous risk factors, though identified, lack unanimous recognition amongst researchers. For example, the majority of papers describe the risk factors for left-sided anastomosis, the principal risk being male sex and lower anastomosis, while little data exists defining AL risk factors in a right colectomy. Also, gut microbioma is gaining an emerging role as potential risk factor for leakage.

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“…No deaths occurred in the DS group, and the reoperation rate decreased when anastomotic leakage occurred, although this was not statistically significant. It is generally believed that a DS may reduce the clinically adverse effects of anastomotic leakage, such as peritonitis and sepsis, rather than prevent leakage (29).…”

Section: Discussionmentioning

confidence: 99%

Diverting Stoma Versus No Diversion in Laparoscopic Low Anterior Resection: A Single-center Retrospective Study in Japan

Wang

Hirano

Ishii

et al. 2019

In Vivo

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Background/Aim: The purpose of this retrospective study was to describe the benefits and risks of a diverting stoma (DS) in laparoscopic low anterior resection (LAR) for rectal cancer. Materials and Methods: A total of 140 and 167 patients without and with DS, respectively, were included in this study in a high-volume cancer center of Japan within an 8-year period. Results: Small bowel obstruction occurred more frequently in patients with DS (2.86% vs. 16.17%, p<0.001). The difference in anastomotic leakage rate was not statistically significant (11.43% vs. 10.18%, p=0.72). In multivariate analysis, the operating time was associated with a higher rate of leakage in LAR [odds ratio (OR) 8.772, 95% confidence interval (CI)=1.002-1.012, p=0.027]. Conclusion: Operating time was associated with a higher rate of leakage in LAR for low rectal cancer. A DS did not reduce anastomotic leakage but increased the risk of postoperative intestinal obstruction in laparoscopic LAR.

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Usefulness of transanal tube placement for prevention of anastomotic leakage following laparoscopic low anterior resection

Abstract: Transanal tube placement prevents AL after LLAR. Furthermore, this protective effect may be due to a reduction in the unfavorable incidence of early postoperative diarrhea.

Cited by 40 publications

References 17 publications

Anastomotic leakage rate following modified double staple technique of anterior resection with vertical division of the rectum for rectal cancer surgery

Anastomotic leakage rate following modified double staple technique of anterior resection with vertical division of the rectum for rectal cancer surgery

Predictive factors for anastomotic leakage after laparoscopic colorectal surgery

Diverting Stoma Versus No Diversion in Laparoscopic Low Anterior Resection: A Single-center Retrospective Study in Japan

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