Use Of A Transanal Drainage Tube In The Prevention Of Anastomotic Leakage After Low Anterior Resection For Rectal Cancer

Objective：to investigate whether the use of a transanal tube can reduce leakage rate afterLAR And the difference in the prevention of AL between the different diameterstransanal tube in order to provide guidance for the choice of clinical treatment.Methods：From January2010and January2013,229patients with rectal cancer underwentlow anterior resection in our hospital. The data of those patients was collected andreviewed retrospectively..those patients divided into test group (165cases) andcontrol group (64cases) depending on whether indwelling anal drainage tube. in thetest group，the patients divided into two subgroups depending on different diameterof anal drainage tube,That is, latex tube group and threaded pipe group.comparingthe test group with the control group and two subgroups in incidence of anastomoticleakage.Results：Patient demographics,preoperative co-morbidity, smoking,ASA score,TNMstage,and operative details were comparable between the two groups in generalanalysis and subgroup analysis. The overall rate of anastomo-tic leakage was4.3%(10of229patients). Patients with transanal tube (n=165) had anastomotic leakage in2.4%(4of165patients) and those without a transanal tube (n=64) in9.4%(6of64patients)(p=0.031), the difference was statistically significant;With regard to thesubgroup,3.7%(4of135) patients with a latex tube presented with anastomoticleakage, compared with0%(0of30) of those with threaded pipe (p=1.000), thedifference was not statistically significant. Univariate analysis showed thatBMI≥25kg/m2,Alb＜35g/dl,Diabetes mellitus(DM) and presence of a transanal tubeappeared to be related to annstomotic leakage.Multivariate logistic regression analysisrevealed that presence of a transanal tube was independent protective factor ofanastomotic leakage, BMI≥25kg/m2and DM were treated as risk factor ofanastomotic leakage.All patients with anastomotic leakage，no one died duing hospitalizationg.Conclusions：The presence of a transanal tube is effective and safe in decreasing the rate ofanastomotic leaks after low anterior resection for rectal cancer with the technique oftotal mesorectal excision and double-staple anastomosis.the latex tube is is similarto threaded pipe in decreasing the rate of anastomotic leaks. presence of a transanaltube was independent protective factor of anastomotic leakage, BMI≥25kg/m2andDM were treated as independent risk factor of anastomotic leakage.