Fujino S, Yasui M, Ohue M, Miyoshi N. Efficacy of transanal drainage tube in preventing anastomotic leakage after surgery for rectal cancer: A meta-analysis. World J Gastrointest Surg 2023; 15(6): 1202-1210 [PMID: 37405086 DOI: 10.4240/wjgs.v15.i6.1202]
Corresponding Author of This Article
Norikatsu Miyoshi, FACS, FASCRS, FICS, MD, PhD, Assistant Professor, Innovative Oncology Research and Regenerative Medicine, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka 541-8567, Japan. nmiyoshi@gesurg.med.osaka-u.ac.jp
Research Domain of This Article
Surgery
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Shiki Fujino, Norikatsu Miyoshi, Innovative Oncology Research and Regenerative Medicine, Osaka International Cancer Institute, Osaka 541-8567, Japan
Masayoshi Yasui, Masayuki Ohue, Department of Surgery, Osaka International Cancer Institute, Osaka 541-8567, Japan
Author contributions: Fujino S, Yasui M, Ohue M, and Miyoshi N designed the research study; Fujino S, Yasui M, and Miyoshi N performed the research; Fujino S and Miyoshi N analyzed the data; Fujino S wrote the manuscript; and all authors have read and approve the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Norikatsu Miyoshi, FACS, FASCRS, FICS, MD, PhD, Assistant Professor, Innovative Oncology Research and Regenerative Medicine, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka 541-8567, Japan. nmiyoshi@gesurg.med.osaka-u.ac.jp
Received: December 26, 2022 Peer-review started: December 26, 2022 First decision: February 21, 2023 Revised: March 21, 2023 Accepted: April 25, 2023 Article in press: April 25, 2023 Published online: June 27, 2023 Processing time: 171 Days and 10.8 Hours
ARTICLE HIGHLIGHTS
Research background
Anastomotic leakage (AL) following rectal cancer surgery remains a serious problem, and transanal drainage tubes (TDTs) and diverting stomas have been performed to avoid AL. However, the efficiency of TDTs results is controversial.
Research motivation
Recently, the two randomized controlled trials (RCTs) on the role of TDT were reported. Therefore, we performed an updated meta-analysis to incorporate them.
Research objectives
We aimed to reveal the role of TDTs in preventing AL after rectal cancer surgery.
Research methods
A systematic literature search was performed using databases and meta-analyses were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.
Research results
TDT did not reduce the symptomatic AL rate in all patients, but TDT reduced the symptomatic AL rate in patients without a diverting stoma.
Research conclusions
TDT may not reduce AL in all patients undergoing rectal cancer surgery. However, patients without a diverting stoma may benefit from TDT placement.
Research perspectives
Rather than viewing TDTs as substitutes for diverting stomas, we must identify high-risk patients, in whom a stoma should be used, and non-high-risk patients, in whom a TDT should be placed to prevent AL.
