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Meta-Analysis
. 2022 Aug;37(8):1739-1750.
doi: 10.1007/s00384-022-04201-y. Epub 2022 Jul 5.

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

Shun-Yu Deng #  1   2 , Jia-Di Xing #  2 , Mao-Xing Liu #  2 , Kai Xu  2 , Fei Tan  2 , Zhen-Dan Yao  2 , Nan Zhang  2 , Hong Yang  2 , Cheng-Hai Zhang  2 , Ming Cui  2 , Xiang-Qian Su  3
Affiliations
Meta-Analysis

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

Shun-Yu Deng et al. Int J Colorectal Dis. 2022 Aug.

Abstract

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.

Keywords: Diverting stoma; Laparoscopic surgery; Rectal cancer; Transanal drainage tube.

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References

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