Multicenter analysis of transanal tube placement for prevention of anastomotic leak after low anterior resection
Background Anastomotic leak (AL) is a serious complication of low anterior resection (LAR). This study aimed to evaluate the effect of transanal tube placement for prevention of AL. Methods This multicenter retrospective cohort study enrolled 328 consecutive patients who underwent LAR for rectal can...
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| Veröffentlicht in: | Journal of surgical oncology 2017-12, Vol.116 (8), p.989-995 |
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| container_title | Journal of surgical oncology |
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| creator | Goto, Saori Hida, Koya Kawada, Kenji Okamura, Ryosuke Hasegawa, Suguru Kyogoku, Takahisa Ota, Shuichi Adachi, Yukito Sakai, Yoshiharu |
| description | Background
Anastomotic leak (AL) is a serious complication of low anterior resection (LAR). This study aimed to evaluate the effect of transanal tube placement for prevention of AL.
Methods
This multicenter retrospective cohort study enrolled 328 consecutive patients who underwent LAR for rectal cancer at participating hospitals from 2009 to 2014. Multivariate logistic regression was used to adjust for confounding factors.
Results
A transanal tube was placed in 205 patients (TA group) and not placed in 123 patients (non‐TA group). Symptomatic AL occurred in 36 cases (11%), with significantly higher incidence of symptomatic AL in the non‐TA group than in the TA group (15% vs 8.3%, odds ratio [OR] 2.02, 95% confidence interval [CI] 1.01‐4.06). After adjusting for confounding factors, multivariate analysis revealed that placement of a transanal tube could decrease the incidence of symptomatic AL (adjusted OR 0.37, 95%CI 0.15‐0.91). There was no significant difference in postoperative morbidity, mortality, length of hospital stay, or local recurrence rate between the two groups. Local recurrence rate tended to be higher in patients with symptomatic AL (3/36) than in those without it (10/292).
Conclusions
Transanal tube placement is effective for decreasing the incidence of symptomatic AL after LAR. |
| doi_str_mv | 10.1002/jso.24760 |
| format | Article |
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Anastomotic leak (AL) is a serious complication of low anterior resection (LAR). This study aimed to evaluate the effect of transanal tube placement for prevention of AL.
Methods
This multicenter retrospective cohort study enrolled 328 consecutive patients who underwent LAR for rectal cancer at participating hospitals from 2009 to 2014. Multivariate logistic regression was used to adjust for confounding factors.
Results
A transanal tube was placed in 205 patients (TA group) and not placed in 123 patients (non‐TA group). Symptomatic AL occurred in 36 cases (11%), with significantly higher incidence of symptomatic AL in the non‐TA group than in the TA group (15% vs 8.3%, odds ratio [OR] 2.02, 95% confidence interval [CI] 1.01‐4.06). After adjusting for confounding factors, multivariate analysis revealed that placement of a transanal tube could decrease the incidence of symptomatic AL (adjusted OR 0.37, 95%CI 0.15‐0.91). There was no significant difference in postoperative morbidity, mortality, length of hospital stay, or local recurrence rate between the two groups. Local recurrence rate tended to be higher in patients with symptomatic AL (3/36) than in those without it (10/292).
Conclusions
Transanal tube placement is effective for decreasing the incidence of symptomatic AL after LAR.</description><identifier>ISSN: 0022-4790</identifier><identifier>EISSN: 1096-9098</identifier><identifier>DOI: 10.1002/jso.24760</identifier><identifier>PMID: 28743178</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Aged ; Anal Canal - surgery ; anastomotic leak ; Anastomotic Leak - prevention & control ; Cancer surgery ; Colorectal cancer ; Female ; Health risk assessment ; Humans ; Logistic Models ; low anterior resection ; Male ; Middle Aged ; Multivariate analysis ; rectal cancer ; Rectal Neoplasms - surgery ; Retrospective Studies ; transanal drainage ; transanal tube</subject><ispartof>Journal of surgical oncology, 2017-12, Vol.116 (8), p.989-995</ispartof><rights>2017 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4540-e9884bc4a25fa5987ed4ee690097a6b836b47b939d9aeb2e37382b2b8ce59353</citedby><cites>FETCH-LOGICAL-c4540-e9884bc4a25fa5987ed4ee690097a6b836b47b939d9aeb2e37382b2b8ce59353</cites><orcidid>0000-0001-7811-7397</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjso.24760$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjso.24760$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28743178$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Goto, Saori</creatorcontrib><creatorcontrib>Hida, Koya</creatorcontrib><creatorcontrib>Kawada, Kenji</creatorcontrib><creatorcontrib>Okamura, Ryosuke</creatorcontrib><creatorcontrib>Hasegawa, Suguru</creatorcontrib><creatorcontrib>Kyogoku, Takahisa</creatorcontrib><creatorcontrib>Ota, Shuichi</creatorcontrib><creatorcontrib>Adachi, Yukito</creatorcontrib><creatorcontrib>Sakai, Yoshiharu</creatorcontrib><title>Multicenter analysis of transanal tube placement for prevention of anastomotic leak after low anterior resection</title><title>Journal of surgical oncology</title><addtitle>J Surg Oncol</addtitle><description>Background
Anastomotic leak (AL) is a serious complication of low anterior resection (LAR). This study aimed to evaluate the effect of transanal tube placement for prevention of AL.
Methods
This multicenter retrospective cohort study enrolled 328 consecutive patients who underwent LAR for rectal cancer at participating hospitals from 2009 to 2014. Multivariate logistic regression was used to adjust for confounding factors.
Results
A transanal tube was placed in 205 patients (TA group) and not placed in 123 patients (non‐TA group). Symptomatic AL occurred in 36 cases (11%), with significantly higher incidence of symptomatic AL in the non‐TA group than in the TA group (15% vs 8.3%, odds ratio [OR] 2.02, 95% confidence interval [CI] 1.01‐4.06). After adjusting for confounding factors, multivariate analysis revealed that placement of a transanal tube could decrease the incidence of symptomatic AL (adjusted OR 0.37, 95%CI 0.15‐0.91). There was no significant difference in postoperative morbidity, mortality, length of hospital stay, or local recurrence rate between the two groups. Local recurrence rate tended to be higher in patients with symptomatic AL (3/36) than in those without it (10/292).
Conclusions
Transanal tube placement is effective for decreasing the incidence of symptomatic AL after LAR.</description><subject>Aged</subject><subject>Anal Canal - surgery</subject><subject>anastomotic leak</subject><subject>Anastomotic Leak - prevention & control</subject><subject>Cancer surgery</subject><subject>Colorectal cancer</subject><subject>Female</subject><subject>Health risk assessment</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>low anterior resection</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>rectal cancer</subject><subject>Rectal Neoplasms - surgery</subject><subject>Retrospective Studies</subject><subject>transanal drainage</subject><subject>transanal tube</subject><issn>0022-4790</issn><issn>1096-9098</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU1PxCAQhonR6Ppx8A8YEi96qEuBFjiajZ_R7MG9N9CdJl1pqdC62X8vdVcPJp6YMM88ZHgROk_JTUoIna6Cu6Fc5GQPTVKi8kQRJffRJPZowoUiR-g4hBUhRKmcH6IjKgVnqZAT1L0Otq9LaHvwWLfabkIdsKtw73UbxgvcDwZwZ3UJTcRw5TzuPHzGunbtiEYq9K5x0YMt6Hesq9Fm3Tq2YlXHCQ8BynHgFB1U2gY4250naHF_t5g9Ji_zh6fZ7UtS8oyTBJSU3JRc06zSmZIClhwgV3EFoXMjWW64MIqppdJgKDDBJDXUyBIyxTJ2gq622s67jwFCXzR1KMFa3YIbQpEqygSPT-URvfyDrtzg4-YjJTOVMiVIpK63VOldCB6qovN1o_2mSEkxplDEFIrvFCJ7sTMOpoHlL_nz7RGYboF1bWHzv6l4fptvlV-IMpK3</recordid><startdate>20171215</startdate><enddate>20171215</enddate><creator>Goto, Saori</creator><creator>Hida, Koya</creator><creator>Kawada, Kenji</creator><creator>Okamura, Ryosuke</creator><creator>Hasegawa, Suguru</creator><creator>Kyogoku, Takahisa</creator><creator>Ota, Shuichi</creator><creator>Adachi, Yukito</creator><creator>Sakai, Yoshiharu</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7811-7397</orcidid></search><sort><creationdate>20171215</creationdate><title>Multicenter analysis of transanal tube placement for prevention of anastomotic leak after low anterior resection</title><author>Goto, Saori ; Hida, Koya ; Kawada, Kenji ; Okamura, Ryosuke ; Hasegawa, Suguru ; Kyogoku, Takahisa ; Ota, Shuichi ; Adachi, Yukito ; Sakai, Yoshiharu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4540-e9884bc4a25fa5987ed4ee690097a6b836b47b939d9aeb2e37382b2b8ce59353</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Anal Canal - surgery</topic><topic>anastomotic leak</topic><topic>Anastomotic Leak - prevention & control</topic><topic>Cancer surgery</topic><topic>Colorectal cancer</topic><topic>Female</topic><topic>Health risk assessment</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>low anterior resection</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>rectal cancer</topic><topic>Rectal Neoplasms - surgery</topic><topic>Retrospective Studies</topic><topic>transanal drainage</topic><topic>transanal tube</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Goto, Saori</creatorcontrib><creatorcontrib>Hida, Koya</creatorcontrib><creatorcontrib>Kawada, Kenji</creatorcontrib><creatorcontrib>Okamura, Ryosuke</creatorcontrib><creatorcontrib>Hasegawa, Suguru</creatorcontrib><creatorcontrib>Kyogoku, Takahisa</creatorcontrib><creatorcontrib>Ota, Shuichi</creatorcontrib><creatorcontrib>Adachi, Yukito</creatorcontrib><creatorcontrib>Sakai, Yoshiharu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Goto, Saori</au><au>Hida, Koya</au><au>Kawada, Kenji</au><au>Okamura, Ryosuke</au><au>Hasegawa, Suguru</au><au>Kyogoku, Takahisa</au><au>Ota, Shuichi</au><au>Adachi, Yukito</au><au>Sakai, Yoshiharu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multicenter analysis of transanal tube placement for prevention of anastomotic leak after low anterior resection</atitle><jtitle>Journal of surgical oncology</jtitle><addtitle>J Surg Oncol</addtitle><date>2017-12-15</date><risdate>2017</risdate><volume>116</volume><issue>8</issue><spage>989</spage><epage>995</epage><pages>989-995</pages><issn>0022-4790</issn><eissn>1096-9098</eissn><abstract>Background
Anastomotic leak (AL) is a serious complication of low anterior resection (LAR). This study aimed to evaluate the effect of transanal tube placement for prevention of AL.
Methods
This multicenter retrospective cohort study enrolled 328 consecutive patients who underwent LAR for rectal cancer at participating hospitals from 2009 to 2014. Multivariate logistic regression was used to adjust for confounding factors.
Results
A transanal tube was placed in 205 patients (TA group) and not placed in 123 patients (non‐TA group). Symptomatic AL occurred in 36 cases (11%), with significantly higher incidence of symptomatic AL in the non‐TA group than in the TA group (15% vs 8.3%, odds ratio [OR] 2.02, 95% confidence interval [CI] 1.01‐4.06). After adjusting for confounding factors, multivariate analysis revealed that placement of a transanal tube could decrease the incidence of symptomatic AL (adjusted OR 0.37, 95%CI 0.15‐0.91). There was no significant difference in postoperative morbidity, mortality, length of hospital stay, or local recurrence rate between the two groups. Local recurrence rate tended to be higher in patients with symptomatic AL (3/36) than in those without it (10/292).
Conclusions
Transanal tube placement is effective for decreasing the incidence of symptomatic AL after LAR.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>28743178</pmid><doi>10.1002/jso.24760</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-7811-7397</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Aged Anal Canal - surgery anastomotic leak Anastomotic Leak - prevention & control Cancer surgery Colorectal cancer Female Health risk assessment Humans Logistic Models low anterior resection Male Middle Aged Multivariate analysis rectal cancer Rectal Neoplasms - surgery Retrospective Studies transanal drainage transanal tube |
| title | Multicenter analysis of transanal tube placement for prevention of anastomotic leak after low anterior resection |
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