Transanal drainage tube for the prevention of anastomotic leakage after rectal cancer surgery: a meta−analysis of randomized controlled trials
BackgroundAnastomotic leakage (AL) is a serious complication of anterior resection for rectal cancer. The use of transanal drainage tubes (TDT) during surgery to prevent AL remains controversial. Therefore, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-05-01
|
| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1198549/full |
| _version_ | 1797823613596860416 |
|---|---|
| author | Shijun Xia Wenjiang Wu Lijuan Ma Lidan Luo Linchong Yu Yue Li |
| author_facet | Shijun Xia Wenjiang Wu Lijuan Ma Lidan Luo Linchong Yu Yue Li |
| author_sort | Shijun Xia |
| collection | DOAJ |
| description | BackgroundAnastomotic leakage (AL) is a serious complication of anterior resection for rectal cancer. The use of transanal drainage tubes (TDT) during surgery to prevent AL remains controversial. Therefore, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to determine the efficacy of TDT in reducing AL.MethodsRelevant data and studies published from inception until November 1, 2022, were retrieved from PubMed, Embase, and Cochrane Library databases to compare the incidence of AL after anterior resection for rectal cancer with and without TDT.ResultsThis meta-analysis included 5 RCTs comprising 1385 patients. The results showed that the intraoperative use of TDT could not reduce the incidence of AL after rectal cancer surgery (risk ratio [RR], 0.91; 95% confidence interval [CI], 0.52–1.59; p = 0.75). A subgroup analysis of different degrees of AL revealed that TDT did not reduce the incidence of postoperative grade B AL (RR, 1.18; 95% CI, 0.67–2.09; p = 0.56) but decreased the incidence of grade C AL (RR, 0.28; 95% CI: 0.12–0.64; p = 0.003). Further, TDT did not reduce the incidence of AL in patients with rectal cancer and a stoma (RR, 2.40; 95% CI, 1.01–5.71; p = 0.05).ConclusionTDT were ineffective in reducing the overall incidence of AL, but they might be beneficial in reducing the incidence of grade C AL in patients who underwent anterior resection. However, additional multicenter RCTs with larger sample sizes based on unified control standards and TDT indications are warranted to validate these findings. |
| first_indexed | 2024-03-13T10:26:29Z |
| format | Article |
| id | doaj.art-157a3569ae514027a5b99902468bb917 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-13T10:26:29Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-157a3569ae514027a5b99902468bb9172023-05-19T06:04:42ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-05-011310.3389/fonc.2023.11985491198549Transanal drainage tube for the prevention of anastomotic leakage after rectal cancer surgery: a meta−analysis of randomized controlled trialsShijun Xia0Wenjiang Wu1Lijuan Ma2Lidan Luo3Linchong Yu4Yue Li5Shenzhen Hospital of Guangzhou University of Chinese Medicine, Futian, Shenzhen, ChinaShenzhen Hospital of Guangzhou University of Chinese Medicine, Futian, Shenzhen, ChinaShenzhen Traditional Chinese Medicine Anorectal Hospital, Futian, Shenzhen, ChinaShenzhen Hospital of Guangzhou University of Chinese Medicine, Futian, Shenzhen, ChinaShenzhen Hospital of Guangzhou University of Chinese Medicine, Futian, Shenzhen, ChinaShenzhen Hospital of Guangzhou University of Chinese Medicine, Futian, Shenzhen, ChinaBackgroundAnastomotic leakage (AL) is a serious complication of anterior resection for rectal cancer. The use of transanal drainage tubes (TDT) during surgery to prevent AL remains controversial. Therefore, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to determine the efficacy of TDT in reducing AL.MethodsRelevant data and studies published from inception until November 1, 2022, were retrieved from PubMed, Embase, and Cochrane Library databases to compare the incidence of AL after anterior resection for rectal cancer with and without TDT.ResultsThis meta-analysis included 5 RCTs comprising 1385 patients. The results showed that the intraoperative use of TDT could not reduce the incidence of AL after rectal cancer surgery (risk ratio [RR], 0.91; 95% confidence interval [CI], 0.52–1.59; p = 0.75). A subgroup analysis of different degrees of AL revealed that TDT did not reduce the incidence of postoperative grade B AL (RR, 1.18; 95% CI, 0.67–2.09; p = 0.56) but decreased the incidence of grade C AL (RR, 0.28; 95% CI: 0.12–0.64; p = 0.003). Further, TDT did not reduce the incidence of AL in patients with rectal cancer and a stoma (RR, 2.40; 95% CI, 1.01–5.71; p = 0.05).ConclusionTDT were ineffective in reducing the overall incidence of AL, but they might be beneficial in reducing the incidence of grade C AL in patients who underwent anterior resection. However, additional multicenter RCTs with larger sample sizes based on unified control standards and TDT indications are warranted to validate these findings.https://www.frontiersin.org/articles/10.3389/fonc.2023.1198549/fullanastomotic leakagetransanal drainage tuberectal canceranterior resectionmeta-analysis |
| spellingShingle | Shijun Xia Wenjiang Wu Lijuan Ma Lidan Luo Linchong Yu Yue Li Transanal drainage tube for the prevention of anastomotic leakage after rectal cancer surgery: a meta−analysis of randomized controlled trials Frontiers in Oncology anastomotic leakage transanal drainage tube rectal cancer anterior resection meta-analysis |
| title | Transanal drainage tube for the prevention of anastomotic leakage after rectal cancer surgery: a meta−analysis of randomized controlled trials |
| title_full | Transanal drainage tube for the prevention of anastomotic leakage after rectal cancer surgery: a meta−analysis of randomized controlled trials |
| title_fullStr | Transanal drainage tube for the prevention of anastomotic leakage after rectal cancer surgery: a meta−analysis of randomized controlled trials |
| title_full_unstemmed | Transanal drainage tube for the prevention of anastomotic leakage after rectal cancer surgery: a meta−analysis of randomized controlled trials |
| title_short | Transanal drainage tube for the prevention of anastomotic leakage after rectal cancer surgery: a meta−analysis of randomized controlled trials |
| title_sort | transanal drainage tube for the prevention of anastomotic leakage after rectal cancer surgery a meta analysis of randomized controlled trials |
| topic | anastomotic leakage transanal drainage tube rectal cancer anterior resection meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1198549/full |
| work_keys_str_mv | AT shijunxia transanaldrainagetubeforthepreventionofanastomoticleakageafterrectalcancersurgeryametaanalysisofrandomizedcontrolledtrials AT wenjiangwu transanaldrainagetubeforthepreventionofanastomoticleakageafterrectalcancersurgeryametaanalysisofrandomizedcontrolledtrials AT lijuanma transanaldrainagetubeforthepreventionofanastomoticleakageafterrectalcancersurgeryametaanalysisofrandomizedcontrolledtrials AT lidanluo transanaldrainagetubeforthepreventionofanastomoticleakageafterrectalcancersurgeryametaanalysisofrandomizedcontrolledtrials AT linchongyu transanaldrainagetubeforthepreventionofanastomoticleakageafterrectalcancersurgeryametaanalysisofrandomizedcontrolledtrials AT yueli transanaldrainagetubeforthepreventionofanastomoticleakageafterrectalcancersurgeryametaanalysisofrandomizedcontrolledtrials |