Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Apr 24, 2025; 16(4): 99801
Published online Apr 24, 2025. doi: 10.5306/wjco.v16.i4.99801
Is the use of a transanal drainage tube effective in treating anastomotic leakage for mid-low rectal cancer
Yu-Kun Cao, Shi-Lai Yang, Zheng-Qiang Wei
Yu-Kun Cao, Shi-Lai Yang, Zheng-Qiang Wei, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400000, China
Author contributions: Cao YK and Wei ZQ contributed to the acquisition of data and analysis, and wrote the manuscript; Cao YK, Yang SL, and Wei ZQ supervised the work, edited the manuscript, made substantial contributions to the conception and design of the study; all of the authors read and approved the final version of the manuscript to be published.
Institutional review board statement: The study was reviewed and approved by The First Affiliated Hospital of Chongqing Medical University Institutional Review Board (No. K2024-119-01).
Informed consent statement: Considering that the research was retrospective, the need for patients’ informed written consent was waived. All patient data utilized in this study were anonymized and de-identified prior to analysis. This ensured that individual patient privacy was protected, and no personal information could be traced back to any specific individual.
Conflict-of-interest statement: All the authors have no conflict of interest related to the manuscript.
Data sharing statement: The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.
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: Zheng-Qiang Wei, MD, Chief Doctor, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, No. 1 You Yi Road, Yuan Jia Gang, Yu Zhong District, Chongqing 400000, China. 13668050652@163.com
Received: July 30, 2024
Revised: January 4, 2025
Accepted: January 18, 2025
Published online: April 24, 2025
Processing time: 238 Days and 17.9 Hours
Abstract
BACKGROUND

Anastomotic leakage (AL) is a severe surgical complication for mid-low rectal cancers. The efficacy of transanal drainage tube (TDT) has rarely been reported.

AIM

To evaluate the efficacy of TDT after AL.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

Keywords: Rectal cancer; Anastomotic leakage; Transanal drainage tube; Low anterior resection syndrome; Therapy

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.