Comparative study between transanal tube and loop ileostomy in low anterior resection for mid rectal cancer: a retrospective single center trial.
10.4174/astr.2015.88.5.260
- Author:
Min Ki KIM
1
;
Dae Youn WON
;
Jin Kwon LEE
;
Won Kyung KANG
;
Jun Gi KIM
;
Seong Taek OH
Author Information
1. Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea. stoh@catholic.ac.kr
- Publication Type:Comparative Study ; Original Article
- Keywords:
Surgical stomas;
Drainage;
Ileostomy;
Anastomotic leak;
Rectal neoplasms
- MeSH:
Anastomotic Leak;
Diet;
Drainage;
Humans;
Ileostomy*;
Length of Stay;
Postoperative Complications;
Rectal Neoplasms*;
Retrospective Studies*;
Surgical Stomas
- From:Annals of Surgical Treatment and Research
2015;88(5):260-268
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To investigate the efficacy and safety of the transanal tube (TAT) in preventing anastomotic leak (AL) in rectal cancer surgery. METHODS: Clinical data of the patients who underwent curative surgery for mid rectal cancer from February 2010 to February 2014 were reviewed retrospectively. Rectal cancers arising 5 to 10 cm above the anal verge were selected. Patients were divided into the ileostomy, TAT, or no-protection groups. Postoperative complications including AL and postoperative course were compared. RESULTS: We included 137 patients: 67, 35, and 35 patients were included in the ileostomy, TAT, and no-protection groups, respectively. Operation time was longer in the ileostomy group (P = 0.029), and more estimated blood loss was observed (P = 0.018). AL occurred in 5 patients (7.5%) in the ileostomy group, 1 patients (2.9%) in the TAT group, and 6 patients (17.1%) in the no-protection group (P = 0.125). Patients in the ileostomy group resumed diet more than 1 day earlier than those in the other groups (P = 0.000). Patients in the no-protection group had about 1 or 2 days longer postoperative hospital stay (P = 0.048). The ileostomy group showed higher late complication rates than the other groups as complications associated with the stoma itself or repair operation developed (P = 0.019). CONCLUSION: For mid rectal cancer surgery, the TAT supports anastomotic site protection and diverts ileostomy-related complications. Further large scale randomized controlled studies are needed to gain more evidence and expand the range of TAT usage.
