Published online Apr 24, 2025. doi: 10.5306/wjco.v16.i4.99801
Revised: January 4, 2025
Accepted: January 18, 2025
Published online: April 24, 2025
Processing time: 238 Days and 17.9 Hours
Anastomotic leakage (AL) is a severe surgical complication for mid-low rectal cancers. The efficacy of transanal drainage tube (TDT) has rarely been reported.
To evaluate the efficacy of TDT after AL.
A retrospective analysis was conducted on 68 patients with mid-low rectal cancer who underwent laparoscopic low anterior resection (LAR) and developed ALs. Leakage were identified using imaging studies and digital rectal examinations when local abscesses or systemic infections were present. In each patient, the leakage site was determined using the index finger and a drainage tube was inserted transanally to drain the abscesses and exudates outside the anus. The clinical outcomes of the patients following transanal drainage were analyzed.
A total of 43 patients received TDT treatment, while 25 patients did not receive TDT treatment. Among the patients in the TDT group, 9 required reoperation compared to 12 in the non-TDT group. In the TDT group, 76.74% of the patients were able to restore intestinal continuity, whereas only 40% of the patients in the non-TDT group achieved restored intestinal continuity. In the TDT group, 48.48% of patients developed LAR syndrome (LARS), whereas in the non-TDT group, 90% of patients developed LARS. The median drainage time was 7 days, the median postoperative hospital stay was 21 days, the median fasting time was 6.5 days, and the median hospitalization cost was 109205.93 RMB.
TDT use lowered reoperation rate but did not increase hospitalization expenses. After ≥ 1 year of follow-up, its use improved intestinal patency rate and reduced the incidence of LARS.
Core Tip: This study compared the efficacy of transanal drainage tubes (TDTs) in patients with middle-to-low rectal cancer who underwent low anterior resection (LAR) and anastomotic leakage (AL). The TDT group had a lower reoperation rate and no increase in hospitalization costs. After at least one year of follow-up, TDT improved the intestinal patency rate and reduced the incidence of LAR syndrome. TDT is an economic and effective method for treating AL after surgery. This study may assist surgeons in making better decisions regarding postoperative AL treatment.