Effect of the transanal drainage tube on preventing anastomotic leakage after laparoscopic surgery for rectal cancer: a systematic review and meta-analysis

• Published in: International journal of colorectal disease Vol. 37; no. 8; pp. 1739 - 1750
• Main Authors: Deng, Shun-Yu, Xing, Jia-Di, Liu, Mao-Xing, Xu, Kai, Tan, Fei, Yao, Zhen-Dan, Zhang, Nan, Yang, Hong, Zhang, Cheng-Hai, Cui, Ming, Su, Xiang-Qian
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2022; Springer; Springer Nature B.V
• Subjects: Anastomotic leak; Cancer; Clinical trials; Colorectal cancer; Complications; DNA nucleotidylexotransferase; Gastroenterology; Hepatology; Internal Medicine; Laparoscopic surgery; Laparoscopy; Medicine; Medicine & Public Health; Meta-analysis; Morbidity; Oncology, Experimental; Patients; Postoperative; Proctology; Rectum; Review; Surgery; Surgical drains; Wound drainage; Laparoscopic surgery; Transanal drainage tube; Diverting stoma; Rectal cancer
• ISSN: 1432-1262; 0179-1958; 1432-1262
• DOI: 10.1007/s00384-022-04201-y

Purpose Anastomotic leakage (AL) is a common postoperative complication of rectal cancer, and transanal drainage tube (TDT) efficacy is still contentious. This study aimed to evaluate the TDT effect on AL prevention. Methods All relevant papers were searched by using a predefined search strategy (two randomized controlled trials (RCTs), one prospective study, and four retrospective studies). Meta-analysis was conducted to estimate AL and re-operation pooled rates. Results A total of 7 studies (1556 patients) were included: No significant statistic difference was found between two groups on AL rate (odds ratio (OR) 0.61, P  = 0.11) and re-operation rate (OR 0.52, P  = 0.10). For subgroup analysis, significant statistic difference was found between two groups on AL rate (OR 0.29, P  = 0.002) and re-operation rate (OR 0.15, P  = 0.04) in patients without neoadjuvant therapy. As for patients without diverting stoma, the AL rate (OR 0.35, P  = 0.002) was significantly lower than that in patients without TDT. Conclusions TDT may reduce AL morbidity and re-operation rate for patients without high risk of AL, but may be useless for those in high-risk situations.