Laparoscopic anterior resection with or without transanal tube for rectal cancer patients – A multicenter randomized controlled trial

In rectal cancer surgery, insertion of transanal tube has been shown to have efficacy to prevent anastomotic leakage. This randomized controlled study aims to clarify the incidence of anastomotic leakage with or without transanal tube in patients with rectal cancer. Patients who underwent elective low anterior resection were randomly allocated to either have transanal tube insertion or not for five days after surgery. We examined the incidence of anastomotic leakage, postoperative 30-day morbidity and mortality. 157 patients were randomized to the transanal tube group or the no-transanal tube group. Symptomatic anastomotic leakage occurred in six patients (7.6%) of the former group and eight patients (10.3%) in the latter group, without significant difference (p = 0.559). There was also no significant difference in morbidity between groups (p = 0.633) and no mortality was detected. Transanal tube insertion had no significant benefit towards prevention of anastomotic leakage in rectal cancer surgery. •Anastomotic leakage is a crucial complication in rectal cancer.•Efficacy of transanal tube for preventing anastomotic leakage is unclear.•Our RCT revealed transanal tube had no significant deterrence of anastomotic leakage.•Transanal tube showed a trend toward preventative effect in male patients.