Transanal Tube for the Prevention of Anastomotic Leakage After Rectal Cancer Surgery: A Systematic Review and Meta-analysis

World J Surg. 2017 Jan;41(1):267-276. doi: 10.1007/s00268-016-3758-9.

Abstract

Background: Transanal tubes (TTs) have been used to prevent and reduce anastomotic leakage after rectal cancer surgery. The aim of this review was to investigate the efficacy and safety of the TT.

Methods: A systematic literature search was performed to identify randomized controlled trials and controlled clinical trials assessing the clinical efficacy and safety of TTs in rectal cancer surgery.

Results: Seven trials with 1609 participants were included. The TT group had a lower anastomotic leakage rate than the non-transanal tube group [RR 0.38; 95 % confidence interval (CI) 0.25-0.58; P < 0.0001], as well as a lower reoperation rate (RR 0.31; 95 % CI 0.19-0.53; P < 0.0001) and a shorter hospital stay (mean = -2.59 days; 95 % CI -3.69 to -1.49; P < 0.0001). There were no significant differences in mortality between the two groups.

Conclusion: TT use in rectal cancer surgery is likely to be an effective and safe method of preventing and reducing anastomotic leakage and is associated with a decreased risk of reoperation and faster recovery.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Anal Canal / surgery*
  • Anastomosis, Surgical / adverse effects*
  • Anastomotic Leak / prevention & control*
  • Drainage / instrumentation*
  • Humans
  • Postoperative Complications / prevention & control
  • Rectal Neoplasms / surgery
  • Reoperation