Langenbeck's archives of surgery · 2015
Impact of anal decompression on anastomotic leakage after low anterior resection for rectal cancer: a propensity score matching analysis.
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Lee Soo Young, Kim Chang Hyun, Kim Young Jin, Kim Hyeong Rok
Аннотация
PURPOSE: The effectiveness of a transanal drainage tube for the prevention of anastomotic leakage (AL) is still uncertain. This study aimed to investigate the impact of anal decompression on AL after rectal cancer surgery.
METHODS: We retrospectively reviewed 536 rectal cancer patients who underwent low anterior resection without diverting stoma, with (n = 154) or without (n = 382) placing of a transanal drainage tube, between January 2005 and December 2014. Risk factors for AL were analyzed, and propensity score matching analysis was used to compensate for the differences in baseline characteristics.
RESULTS: AL occurred in 50 (9.3%) of the patients. Male sex (odds ratio [OR] 3.097, p = 0.005), high ASA score (OR 3.505, p = 0.025), and neoadjuvant chemoradiation (OR 2.506, p = 0.018) were independent predictors of AL on multivariable analysis. After propensity score matching, transanal drainage tube tended to lessen rates of grade C AL with definite peritonitis (1.9 vs. 5.8%, p = 0.077), although there was no difference in the incidence of AL in patients with or without transanal drainage tubes (5.8 vs. 9.1%, p = 0.278).
CONCLUSIONS: Placement of a transanal drainage tube was not associated with a reduction in the total incidence of AL after low anterior resection for rectal cancer.
METHODS: We retrospectively reviewed 536 rectal cancer patients who underwent low anterior resection without diverting stoma, with (n = 154) or without (n = 382) placing of a transanal drainage tube, between January 2005 and December 2014. Risk factors for AL were analyzed, and propensity score matching analysis was used to compensate for the differences in baseline characteristics.
RESULTS: AL occurred in 50 (9.3%) of the patients. Male sex (odds ratio [OR] 3.097, p = 0.005), high ASA score (OR 3.505, p = 0.025), and neoadjuvant chemoradiation (OR 2.506, p = 0.018) were independent predictors of AL on multivariable analysis. After propensity score matching, transanal drainage tube tended to lessen rates of grade C AL with definite peritonitis (1.9 vs. 5.8%, p = 0.077), although there was no difference in the incidence of AL in patients with or without transanal drainage tubes (5.8 vs. 9.1%, p = 0.278).
CONCLUSIONS: Placement of a transanal drainage tube was not associated with a reduction in the total incidence of AL after low anterior resection for rectal cancer.
Предметные рубрики MeSH
AgedAged, 80 and overAnal CanalAnalysis of VarianceAnastomosis, SurgicalAnastomotic LeakCase-Control StudiesConfidence IntervalsDatabases, FactualDecompression, SurgicalDisease-Free SurvivalDrainageFemaleHumansMaleMiddle AgedMultivariate AnalysisOdds RatioProctocolectomy, RestorativePrognosisPropensity ScoreRectal NeoplasmsRetrospective StudiesRisk AssessmentSurvival AnalysisTreatment Outcome