- Transanal Tube Drainage as a Conservative Treatment for Anastomotic Leakage Following a Rectal Resection
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Mostafa Shalaby, Waleed Thabet, Oreste Buonomo, Nicola Di Lorenzo, Mosaad Morshed, Giuseppe Petrella, Mohamed Farid, Pierpaolo Sileri
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Ann Coloproctol. 2018;34(6):317-321. Published online December 20, 2018
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DOI: https://doi.org/10.3393/ac.2017.10.18
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 Abstract
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- Purpose
We evaluate the role of transanal tube drainage (TD) as a conservative treatment for patients with anastomotic leakage (AL).
Methods
Patients treated for AL who had undergone a low or an ultralow anterior resection with colorectal or coloanal anastomosis for the treatment of rectal cancer between January 2013 and January 2017 were enrolled in this study. The data were collected prospectively and analyzed retrospectively. The primary outcomes were the diagnosis and the management of AL.
Results
Two hundred thirteen consecutive patients, 122 males and 91 females, were included. The mean age was 66.91 ± 11.15 years, and the median body mass index was 24 kg/m2 (range, 20–35 kg/m2 ). The median tumor distance from the anal verge was 8 cm (range, 4–12 cm). Ninety-three patients (44%) received neoadjuvant therapy for nodal disease and/or locally advanced rectal cancer. Only 13 patients (6%) developed AL. Six patients developed subclinical AL as they had a defunctioning ileostomy at the time of the initial procedure. They were treated conservatively with TD under endoscopic guidance in the endoscopy unit and received intravenous antibiotics. Six weeks after discharge, these 6 patients underwent follow-up flexible sigmoidoscopy which showed a completely healed anastomotic defect with no residual stenosis. Seven patients developed a clinically significant AL and required reoperation with pelvic abscess drainage and Hartmann colostomy formation.
Conclusion
These results suggest that TD for management of patients with AL is safe, cheap, and effective. Salvaging the anastomosis will help decrease the need for Hartmann colostomy formation. Proper patient selection is important.
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Citations
Citations to this article as recorded by  - Challenges in the interdisciplinary treatment of leakages after left-sided colorectal surgery: endoscopic negative pressure therapy, open-pore film drainage therapy and beyond
Pasquale Scognamiglio, Anja Seeger, Matthias Reeh, Nathaniel Melling, Karl F Karstens, Thomas Rösch, Jakob R Izbicki, Marcus Kantowski, Michael Tachezy
International Journal of Colorectal Disease.2023;[Epub] CrossRef - Significance of information obtained during transanal drainage tube placement after anterior resection of colorectal cancer
Yuki Okazaki, Masatsune Shibutani, Hisashi Nagahara, Tatsunari Fukuoka, Yasuhito Iseki, En Wang, Kiyoshi Maeda, Kosei Hirakawa, Masaichi Ohira, Zubing Mei
PLOS ONE.2022; 17(8): e0271496. CrossRef - The usefulness of transanal tube for reducing anastomotic leak in mid rectal cancer: compared to diverting stoma
Seok Hyeon Cho, In Kyu Lee, Yoon Suk Lee, Min Ki Kim
Annals of Surgical Treatment and Research.2021; 100(2): 100. CrossRef - Treatment Modalities for Anastomotic Leakage in Rectal Cancer Surgery
Deborah S. Keller, K. Talboom, C.P.M van Helsdingen, Roel Hompes
Clinics in Colon and Rectal Surgery.2021; 34(06): 431. CrossRef - Retrospective study of active drainage in the management of anastomotic leakage after anterior resection for rectal cancer
Xiaojie Tan, Mei Zhang, Lai Li, He Wang, Xiaodong Liu, Haitao Jiang
Journal of International Medical Research.2021;[Epub] CrossRef - Improved colorectal anastomotic leakage healing by transanal rinsing treatment after endoscopic vacuum therapy using a novel patient-applied rinsing catheter
Marcus Kantowski, Andreas Kunze, Eugen Bellon, Thomas Rösch, Utz Settmacher, Michael Tachezy
International Journal of Colorectal Disease.2020; 35(1): 109. CrossRef - Surgical complications in colorectal cancer patients
Haleh Pak, Leila Haji Maghsoudi, Ali Soltanian, Farshid Gholami
Annals of Medicine and Surgery.2020; 55: 13. CrossRef - Effect comparison of three different types of transanal drainage tubes after anterior resection for rectal cancer
Yun Luo, Chang-Kang Zhu, Ding-Quan Wu, Liang-Bi Zhou, Chong-Shu Wang
BMC Surgery.2020;[Epub] CrossRef - Percutaneous transesophageal gastro-tubing for the management of anastomotic leakage after upper GI surgery: a report of two clinical cases
Yutaka Tamamori, Katsunobu Sakurai, Naoshi Kubo, Ken Yonemitsu, Yasuhiro Fukui, Junya Nishimura, Kiyoshi Maeda, Yukio Nishiguchi
Surgical Case Reports.2020;[Epub] CrossRef - Long-Term Results after Anastomotic Leakage following Rectal Cancer Surgery: A Comparison of Treatment with Endo-Sponge and Transanal Irrigation
Alice Weréen, Martin Dahlberg, Göran Heinius, Emil Pieniowski, Deborah Saraste, Karolina Eklöv, Jonas Nygren, Klas Pekkari, Åsa H. Everhov
Digestive Surgery.2020; 37(6): 456. CrossRef - Preventive strategies for anastomotic leakage after colorectal resections: A review
Mostafa Shalaby, Waleed Thabet, Mosaad Morshed, Mohamed Farid, Pierpaolo Sileri
World Journal of Meta-Analysis.2019; 7(8): 389. CrossRef - Transanal surgery: A tool in colorectal anastomotic leakage
Pere Planellas Giné, Júlia Gil Garcia, Ramon Farrés Coll, Antoni Codina Cazador
Cirugía Española (English Edition).2019; 97(10): 590. CrossRef - La cirugía transanal como herramienta en la dehiscencia de la anastomosis colorrectal
Pere Planellas Giné, Júlia Gil Garcia, Ramon Farrés Coll, Antoni Codina Cazador
Cirugía Española.2019; 97(10): 590. CrossRef
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