Abstract
BackgroundColorectal cancer (CRC) is the most common tumor of the gastrointestinal tract. Anastomotic leak (AL) and prolonged postoperative ileus (PPOI) are two important complications of colorectal surgery. In this observational retrospective study, we evaluated the positive effects of transanal tube No Coil® in patients with CRC undergoing low anterior resection (LAR) and left hemicolectomy (LC).MethodsThirty-eight cases and forty controls resulted eligible for the final sample. No Coil® placement (SapiMed Spa, Alessandria, Italy) was considered an inclusion criteria for the case group. No Coil® was placed immediately after the end of surgical treatment.ResultsPPOI was significantly more frequent in the control group. AL was evident in 1 patient (2.6%) of cases and 3 patients (7.5%) of controls. No statistical difference was found in AL occurrence between groups. POI days and AL resulted associated with hospital stay. POI days were negatively associated with No Coil placement and positively with AL.ConclusionWith our preliminary data, we suggest that No Coil® placement can be considered as a valuable procedure assisting colorectal surgery, but further studies are required to confirm and enlarge actual evidence.
Highlights
Colorectal cancer (CRC) is the most frequent tumor of the gastrointestinal tract, and its predicted prevalence is estimated to rise up to 2.5 million in 2035 [1, 2].During 2018, 704.000 new cases of rectal cancer (RC) have been reported for which low anterior resection (LAR) remains the cornerstone of curative intent treatment, providing the best results in terms of quality of life [3, 4]
All participants were screened with serum carcinoebryonic antigen (CEA) and carbohydrate antigen 19.9 (CA-19.9) blood level measurement, total body computed tomography (CT), and colonoscopy, and histopathological grading was performed according to the American Joint of Committee on Cancer (AJCC) 8th Edition
Anastomotic leak (AL) was evident in 1 patient (2.6%) of cases and 3 patients (7.5%) of controls; AL in 1 patient of cases (LAR group) was treated conservatively with total parenteral nutrition and transanal tube No Coil removed on the 12th day; AL in 3 patients of the control group (2 LAR group; 1 left hemicolectomy (LC) group) was treated with loop colostomy
Summary
No differences emerged in gender and age distribution between groups. Mean hospital stay was 12.1 ± 4.7 days in cases and 16.6 ± 6.8 days in controls, with significance between groups (F = 4.164; t = 3.494; p = 0.001) (Fig. 2). PPOI was significantly more frequent in controls (40, 100%) than in cases (9, 23.7%) (χ2 = 48.593; p < 0.001), and POI mean duration was significantly higher in controls (Table 1; Fig. 3). POI days and AL resulted associated with hospital stay, explaining 45% of the variance (Table 2). POI days were negatively associated with No Coil placement and positively with AL (Table 2).
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