Transanal drainage tube for prevention of anastomotic leak after anterior resection for rectal cancer: a meta-analysis.
10.3760/cma.j.cn441530-20221125-00493
- Author:
Cheng Ren ZHANG
1
;
Shi Yun XU
2
;
Yao Chun LV
2
;
Bin Bin DU
2
;
De Wang WU
2
;
Jing Jing LI
2
;
Cheng Zhang ZHU
2
;
Xiong Fei YANG
2
Author Information
1. Department of Anorectal Surgery, Gansu Provincial People's Hospital, Lanzhou 730000, China Clinical Research Center for Anorectal Diseases of Gansu Province, Lanzhou 730000, China Clinical Medical College of Ningxia Medical University, Yinchuan 750000, China.
2. Department of Anorectal Surgery, Gansu Provincial People's Hospital, Lanzhou 730000, China Clinical Research Center for Anorectal Diseases of Gansu Province, Lanzhou 730000, China.
- Publication Type:Journal Article
- MeSH:
Humans;
Anastomotic Leak/etiology*;
Rectal Neoplasms/complications*;
Drainage;
Anastomosis, Surgical/adverse effects*;
Reoperation/adverse effects*;
Hemorrhage;
Retrospective Studies
- From:
Chinese Journal of Gastrointestinal Surgery
2023;26(7):689-696
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To assess the effectiveness of transanal drainage tube (TDT) in reducing the incidence of anastomotic leak following anterior resection in patients with rectal cancer. Methods: We conducted a systematic search for relevant studies published from inception to October 2022 across multiple databases, including PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP. Meta-analysis was performed using Review Manager 5.4 software. The primary outcomes included total incidence of anastomotic leak, grade B and C anastomotic leak rates, reoperation rate, anastomotic bleeding rate, and overall complication rate. Results: Three randomized controlled trials involving 1115 patients (559 patients in the TDT group and 556 in the non-TDT group) were included. Meta-analysis showed that the total incidences of anastomotic leak and of grade B anastomotic leak were 5.5% (31/559) and 4.5% (25/559), respectively, in the TDT group and 7.9% (44/556) and 3.8% (21/556), respectively, in the non-TDT group. These differences are not statistically significant (P=0.120, P=0.560, respectively). Compared with the non-TDT group, the TDT group had a lower incidence of grade C anastomotic leak (1.6% [7/559] vs. 4.5% [25/556]) and reoperation rate (0.9% [5/559] vs. 4.3% [24/556]), but a higher incidence of anastomotic bleeding (8.2% [23/279] vs. 3.6% [10/276]). These differences were statistically significant (P=0.003, P=0.001, P=0.030, respectively). The overall complication rate was 26.5%(74/279) in the TDT group and 27.2% (75/276) in the non-TDT group. These differences are not statistically significant (P=0.860). Conclusions: TDT did not significantly reduce the total incidence of anastomotic leak but may have potential clinical benefits in preventing grade C anastomotic leak. Notably, placement of TDT may increase the anastomotic bleeding rate.
