Efficacy of transanal tube for prevention of anastomotic leakage following laparoscopic low anterior resection for rectal cancers: a retrospective cohort study in a single institution.

Abstract

Anastomotic leakage is one of the most serious complications following laparoscopic low anterior resection (LAR) for rectal cancers. The purpose of this study was to investigate whether transanal tube placement can reduce anastomotic leakage following laparoscopic LAR. Retrospective assessment was performed on 205 patients with rectal cancers who underwent laparoscopic LAR. A transanal tube was placed after anastomosis in 96 patients (group A). Another 109 patients were operated on without a transanal tube (group B). Clinicopathological and operative variables, the frequencies of anastomotic leakage and re-operation after leakage were investigated. Patient age, gender, body mass index, tumor size, Dukes' stage, intra-operative blood loss, and the rate of left colic artery preservation were comparable between the two groups. Tumor location was lower and operative time was significantly longer in group A than group B (p<0.001). Overall rate of leakage was 9.3% (19/205). The frequency of leakage was 4.2% (4/96) in group A and was 13.8% (15/109) in group B. The rate of leakage was significantly lower in group A (p<0.05). Furthermore, the re-operation rate for symptomatic anastomotic leakage was 0% (0/4) in group A, while in contrast it was 73.3% (10/15) in group B. The rate of re-operation was lower in group A than group B (p<0.05) and all cases with symptomatic leakage in group A were cured by conservative treatment. Transanal tube placement was effective for prevention of anastomotic leakage following laparoscopic LAR and avoiding re-operation after symptomatic leakage.