Comparative Study of Large-Calibre Transanal Tube Usage after Rectal Cancer Anterior Resection for Prophylaxis of Anastomotic Leakage_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

TU Xiaohuang , ZHANG Zaizhong , SONG Jingxiang , CHEN Shaoquan , LI Chengjin

Research Institute of General Surgery， Fuzhou General Hospital of Nanjing Military Command, Fuzhou 350025, ChinaCorresponding Author: TU Xiao-huang, E-mail: fzptwk@163.com;

Corresponding author：

Keywords：

Rectal cancer anterior resection; Anastomotic leakage; Large-calibre transanal tube; Drainage; Decompression

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Abstract Full text Figures/Tables Video References Cited by

Objective 　To assess the effectiveness of large-calibre (7.5#) transanal tube drainage and decompression on prevention from anastomotic leakage following anterior resection for rectal cancer.
Methods 　Clinical data of 346 consecutive patients (M/F=1.39, age range 32-84 years, median age 58.5 years) undergone anterior resection for rectal cancer in this institute from January 2006 to December 2008 were analyzed retrospectively.
Results 　The anastomotic leakage rate was 0 (0/185) and 5.59%(9/161) in patients with or without receiving large-calibre transanal tube drainage respectively. The anastomotic leakage rate was significantly decreased by large-calibre transanal tube drainage after anterior resection for rectal cancer (χ2=8.526, P=0.004). Eight cases of anastomotic leakage were treated conservatively and the other one required further surgical interventions. No perioperative death occurred in this series.
Conclusion 　In this study, the large-calibre transanal tube drainage and decompression is effective in protecting rectal anastomosis and decreasing the rate of anastomotic leakage.

Citation： TU Xiaohuang,ZHANG Zaizhong,SONG Jingxiang,CHEN Shaoquan,LI Chengjin. Comparative Study of Large-Calibre Transanal Tube Usage after Rectal Cancer Anterior Resection for Prophylaxis of Anastomotic Leakage. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(10): 830-833. doi: Copy

1.	Kanellos I, Vasiliadis K, Angelopoulos S, et al. Anastomotic leakage following anterior resection for rectal cancer [Ｊ]. Tech Coloproctol, 2004; 8 Suppl 1: s79-s81.
2.	李永军, 李明, 顾晋. 直肠癌全直肠系膜切除术后吻合口漏的危险因素分析 [Ｊ]. 中华普通外科杂志, 2008; 23(4): 248-250.
3.	黄士勇, 孟荣贵. 直肠癌术后吻合口漏的危险因素分析 [Ｊ]. 中华外科杂志, 2008; 46(4): 309-310.
4.	李世拥. 进一步加强结直肠癌外科规范化治疗 [Ｊ]. 中华外科杂志, 2007; 45(7): 433-435.
5.	Madoff RD. Rectal cancer: optimum treatment leads to optimum results [Ｊ]. Lancet, 2009; 373(9666): 790-792.
6.	Kapiteijn E, Marijnen CA, Nagtegaal ID, et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer [Ｊ]. N Engl J Med, 2001; 345(9): 638-646.
7.	赵广法, 师英强, 莫善克. 直肠全系膜切除术后吻合口漏的危险因素分析和对策 [Ｊ]. 肿瘤, 2004; 24(6): 595-597.
8.	董新舒, 徐海涛, 王平, 等. 915例直肠癌前切除术后并发症临床分析 [Ｊ]. 中国实用外科杂志, 2008; 28(2): 136-138.
9.	屠世良, 邓高里, 董全进, 等. 新型肠内引流预防低位直肠吻合口瘘的临床研究 [Ｊ]. 中华胃肠外科杂志, 2008; 11(3): 223-227.
10.	Bertelsen CA, Andreasen AH, Jrgensen T, et al. Anastomotic leakage after anterior resection for rectal cancer: risk factors [Ｊ]. Colorectal Dis, 2008 Oct 17, [Epub ahead of print].
11.	董功航, 汪建平, 邓艳红, 等. 术前经新辅助治疗的中低位直肠癌患者吻合口漏的预防和治疗 [Ｊ]. 中华普通外科杂志, 2009; 24(2): 100-102.
12.	Jestin P, Phlman L, Gunnarsson U. Risk factors for anastomotic leakage after rectal cancer surgery: a case-control study [Ｊ]. Colorectal Dis, 2008; 10(7): 715-721.
13.	Matthiessen P, Hallbk O, Andersson M, et al. Risk factors for anastomotic leakage after anterior resection of the rectum [Ｊ]. Colorectal Dis, 2004; 6(6): 462-469.
14.	刘荫华. 低位直肠癌吻合口漏和直肠阴道瘘的预防与处理 [Ｊ]. 中国实用外科杂志, 2007; 27(6): 448-450.
15.	张明德, 高友福, 王宏强, 等. 直肠癌前切除吻合口漏发生原因分析及预防 [Ｊ]. 中国普外基础与临床杂志， 2000; 7（5）： 315-317.
16.	涂小煌, 王烈主编. 直肠癌全直肠系膜切除术 [M]. 福州: 福建科学技术出版社, 2006: 88-89.
17.	Lee WS, Yun SH, Roh YN, et al. Risk factors and clinical outcome for anastomotic leakage after total mesorectal excision for rectal cancer [Ｊ]. World J Surg, 2008; 32(6): 1124-1129.
18.	董小牛, 夏晓峰, 陈贵平, 等. 盆腔双管引流加肛管减压预防直肠癌保肛术后吻合口瘘的分析 [Ｊ]. 浙江临床医学, 2005; 7(4): 376.
19.	高峰, 闫于悌, 宋岚, 等. 直肠肛管内外双引流预防直肠低位吻合口瘘的发生 [Ｊ]. 中华胃肠外科杂志, 2008; 11(6): 584-585.
20.	Sterk P, Schubert F, Günter S, et al. Anastomotic protection with a transanal tube after rectum resection and total mesorectal excision [Ｊ]. Zentralbl Chir, 2001; 126(8): 601-604.
21.	陈继贵, 路直美, 陈华荣, 等. 直肠癌前切除术吻合口漏预防方法的探讨 [Ｊ]. 中国普外基础与临床杂志, 2007; 14(3): 329-330.
22.	黄伟民, 李洪涛, 杨明, 等. 直肠癌双吻合器保肛术吻合口漏的预防和治疗(附81例报告) [Ｊ]. 中国普外基础与临床杂志, 2005; 12(1): 40-41.
23.	王健，付金强，郑成军, 等. 腹腔镜结直肠癌根治术吻合口漏的预防 [Ｊ]. 现代预防医学, 2009; 36(11): 2157-2158.

1. Kanellos I, Vasiliadis K, Angelopoulos S, et al. Anastomotic leakage following anterior resection for rectal cancer [Ｊ]. Tech Coloproctol, 2004; 8 Suppl 1: s79-s81.
2. 李永军, 李明, 顾晋. 直肠癌全直肠系膜切除术后吻合口漏的危险因素分析 [Ｊ]. 中华普通外科杂志, 2008; 23(4): 248-250.
3. 黄士勇, 孟荣贵. 直肠癌术后吻合口漏的危险因素分析 [Ｊ]. 中华外科杂志, 2008; 46(4): 309-310.
4. 李世拥. 进一步加强结直肠癌外科规范化治疗 [Ｊ]. 中华外科杂志, 2007; 45(7): 433-435.
5. Madoff RD. Rectal cancer: optimum treatment leads to optimum results [Ｊ]. Lancet, 2009; 373(9666): 790-792.
6. Kapiteijn E, Marijnen CA, Nagtegaal ID, et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer [Ｊ]. N Engl J Med, 2001; 345(9): 638-646.
7. 赵广法, 师英强, 莫善克. 直肠全系膜切除术后吻合口漏的危险因素分析和对策 [Ｊ]. 肿瘤, 2004; 24(6): 595-597.
8. 董新舒, 徐海涛, 王平, 等. 915例直肠癌前切除术后并发症临床分析 [Ｊ]. 中国实用外科杂志, 2008; 28(2): 136-138.
9. 屠世良, 邓高里, 董全进, 等. 新型肠内引流预防低位直肠吻合口瘘的临床研究 [Ｊ]. 中华胃肠外科杂志, 2008; 11(3): 223-227.
10. Bertelsen CA, Andreasen AH, Jrgensen T, et al. Anastomotic leakage after anterior resection for rectal cancer: risk factors [Ｊ]. Colorectal Dis, 2008 Oct 17, [Epub ahead of print].
11. 董功航, 汪建平, 邓艳红, 等. 术前经新辅助治疗的中低位直肠癌患者吻合口漏的预防和治疗 [Ｊ]. 中华普通外科杂志, 2009; 24(2): 100-102.
12. Jestin P, Phlman L, Gunnarsson U. Risk factors for anastomotic leakage after rectal cancer surgery: a case-control study [Ｊ]. Colorectal Dis, 2008; 10(7): 715-721.
13. Matthiessen P, Hallbk O, Andersson M, et al. Risk factors for anastomotic leakage after anterior resection of the rectum [Ｊ]. Colorectal Dis, 2004; 6(6): 462-469.
14. 刘荫华. 低位直肠癌吻合口漏和直肠阴道瘘的预防与处理 [Ｊ]. 中国实用外科杂志, 2007; 27(6): 448-450.
15. 张明德, 高友福, 王宏强, 等. 直肠癌前切除吻合口漏发生原因分析及预防 [Ｊ]. 中国普外基础与临床杂志， 2000; 7（5）： 315-317.
16. 涂小煌, 王烈主编. 直肠癌全直肠系膜切除术 [M]. 福州: 福建科学技术出版社, 2006: 88-89.
17. Lee WS, Yun SH, Roh YN, et al. Risk factors and clinical outcome for anastomotic leakage after total mesorectal excision for rectal cancer [Ｊ]. World J Surg, 2008; 32(6): 1124-1129.
18. 董小牛, 夏晓峰, 陈贵平, 等. 盆腔双管引流加肛管减压预防直肠癌保肛术后吻合口瘘的分析 [Ｊ]. 浙江临床医学, 2005; 7(4): 376.
19. 高峰, 闫于悌, 宋岚, 等. 直肠肛管内外双引流预防直肠低位吻合口瘘的发生 [Ｊ]. 中华胃肠外科杂志, 2008; 11(6): 584-585.
20. Sterk P, Schubert F, Günter S, et al. Anastomotic protection with a transanal tube after rectum resection and total mesorectal excision [Ｊ]. Zentralbl Chir, 2001; 126(8): 601-604.
21. 陈继贵, 路直美, 陈华荣, 等. 直肠癌前切除术吻合口漏预防方法的探讨 [Ｊ]. 中国普外基础与临床杂志, 2007; 14(3): 329-330.
22. 黄伟民, 李洪涛, 杨明, 等. 直肠癌双吻合器保肛术吻合口漏的预防和治疗(附81例报告) [Ｊ]. 中国普外基础与临床杂志, 2005; 12(1): 40-41.
23. 王健，付金强，郑成军, 等. 腹腔镜结直肠癌根治术吻合口漏的预防 [Ｊ]. 现代预防医学, 2009; 36(11): 2157-2158.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Comparative Study of Large-Calibre Transanal Tube Usage after Rectal Cancer Anterior Resection for Prophylaxis of Anastomotic Leakage

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