Effectiveness of a large-calibre transanal drainage tube on the prevention of anastomotic leakage after anterior resection for rectal cancer.

PURPOSE: Anastomotic leakage (AL) is one of the most serious complications of colorectal surgery. We investigated whether the large-calibre transanal drainage tube (LTDT) placement could reduce AL after anterior resection for rectal cancer.

METHODS

We restrospectively analyzed 222 patients who underwent anterior resection at our institution. The patients were divided into the large-calibre transanal drainage tube (LTDT) and non-transanal drainage tube (NTDT) groups according to whether the large-calibre transanal drainage tube was placed in the operation. Clinical characteristics and postoperative complication were compared between the LTDT and NTDT groups.

RESULTS

In the LTDT group, AL occurred in 0 patient, whereas it occurred in 9 patients in the NTDT group. The rate of AL was significantly lower in the LTDT group (0 vs. 6.6%; p=0.015). Eight cases of AL were treated conservatively. One case developed severe peritonitis and underwent re-operation receiving temporary stoma.No perioperative death occurred in this series.

CONCLUSIONS

The large-calibre transanal drainage tube effectively prevented the occurrence of anastomotic leakage after anterior resection for rectal cancer and increased the safety of the surgery.