Impacts of trans‐anal tube placement in patients with sigmoid colon cancer: Risk verification analysis using inverse probability weighting analysis
Abstract Purpose Anastomotic leakage (AL) is a serious postoperative complication that affects short‐ and long‐term outcomes. The use of a trans‐anal drainage tube (TDT) is reported to prevent AL in rectal cancer patients, but its value in sigmoid colon cancer patients is unknown. Methods Admitted t...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-03-01
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| Series: | Annals of Gastroenterological Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ags3.12634 |
| _version_ | 1827978180117397504 |
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| author | Tetsuro Tominaga Takashi Nonaka Toshio Shiraishi Hiroshi Yano Shuntaro Sato Akiko Fukuda Makoto Hisanaga Shintaro Hashimoto Terumitsu Sawai Takeshi Nagayasu |
| author_facet | Tetsuro Tominaga Takashi Nonaka Toshio Shiraishi Hiroshi Yano Shuntaro Sato Akiko Fukuda Makoto Hisanaga Shintaro Hashimoto Terumitsu Sawai Takeshi Nagayasu |
| author_sort | Tetsuro Tominaga |
| collection | DOAJ |
| description | Abstract Purpose Anastomotic leakage (AL) is a serious postoperative complication that affects short‐ and long‐term outcomes. The use of a trans‐anal drainage tube (TDT) is reported to prevent AL in rectal cancer patients, but its value in sigmoid colon cancer patients is unknown. Methods Admitted to the study were 379 patients who underwent surgery for sigmoid colon cancer between 2016 and 2020. Patients were divided into two groups according to the placement (n = 197) or nonplacement of a TDT (n = 182). To determine the factors affecting the association between TDT placement and AL, we estimated average treatment effects by stratifying each factor using the inverse probability of treatment weighting method. The association between prognosis and AL was evaluated in each identified factor. Results Factors associated with postsurgical insertion of a TDT were advanced age, male sex, high body mass index (BMI), poor performance status, and presence of comorbidities. TDT placement was associated with a significantly lower AL in male patients (odds ratio [OR], 0.22; 95% confidence interval [CI], 0.07–0.73; P = .013) and for BMI ≥ 25 kg/m2 (OR, 0.13; 95% CI, 0.02–0.65; P = .013). In addition, there was a significant association of AL with poor prognosis in patients with BMI ≥ 25 kg/m2 (P = .043), age > 75 y (P = .021), and pathological node‐positive disease (P = .015). Conclusion Sigmoid colon cancer patients with BMI ≥ 25 kg/m2 are the most appropriate candidates for postoperative TDT insertion, in terms of reduced incidence of AL and improved prognosis. |
| first_indexed | 2024-04-09T21:16:48Z |
| format | Article |
| id | doaj.art-eb5dc5baeb6d4304a385d1d06c1994dd |
| institution | Directory Open Access Journal |
| issn | 2475-0328 |
| language | English |
| last_indexed | 2024-04-09T21:16:48Z |
| publishDate | 2023-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Gastroenterological Surgery |
| spelling | doaj.art-eb5dc5baeb6d4304a385d1d06c1994dd2023-03-28T08:33:09ZengWileyAnnals of Gastroenterological Surgery2475-03282023-03-017227928610.1002/ags3.12634Impacts of trans‐anal tube placement in patients with sigmoid colon cancer: Risk verification analysis using inverse probability weighting analysisTetsuro Tominaga0Takashi Nonaka1Toshio Shiraishi2Hiroshi Yano3Shuntaro Sato4Akiko Fukuda5Makoto Hisanaga6Shintaro Hashimoto7Terumitsu Sawai8Takeshi Nagayasu9Department of Surgical Oncology Nagasaki University Graduate School of Biomedical Science Nagasaki JapanDepartment of Surgical Oncology Nagasaki University Graduate School of Biomedical Science Nagasaki JapanDepartment of Surgical Oncology Nagasaki University Graduate School of Biomedical Science Nagasaki JapanClinical Research Center Nagasaki University Hospital Nagasaki JapanClinical Research Center Nagasaki University Hospital Nagasaki JapanDepartment of Surgery Sasebo City General Hospital Nagasaki JapanDepartment of Surgery Isahaya General Hospital Nagasaki JapanDepartment of Surgery Ureshino Medical Center Saga JapanDepartment of Surgical Oncology Nagasaki University Graduate School of Biomedical Science Nagasaki JapanDepartment of Surgical Oncology Nagasaki University Graduate School of Biomedical Science Nagasaki JapanAbstract Purpose Anastomotic leakage (AL) is a serious postoperative complication that affects short‐ and long‐term outcomes. The use of a trans‐anal drainage tube (TDT) is reported to prevent AL in rectal cancer patients, but its value in sigmoid colon cancer patients is unknown. Methods Admitted to the study were 379 patients who underwent surgery for sigmoid colon cancer between 2016 and 2020. Patients were divided into two groups according to the placement (n = 197) or nonplacement of a TDT (n = 182). To determine the factors affecting the association between TDT placement and AL, we estimated average treatment effects by stratifying each factor using the inverse probability of treatment weighting method. The association between prognosis and AL was evaluated in each identified factor. Results Factors associated with postsurgical insertion of a TDT were advanced age, male sex, high body mass index (BMI), poor performance status, and presence of comorbidities. TDT placement was associated with a significantly lower AL in male patients (odds ratio [OR], 0.22; 95% confidence interval [CI], 0.07–0.73; P = .013) and for BMI ≥ 25 kg/m2 (OR, 0.13; 95% CI, 0.02–0.65; P = .013). In addition, there was a significant association of AL with poor prognosis in patients with BMI ≥ 25 kg/m2 (P = .043), age > 75 y (P = .021), and pathological node‐positive disease (P = .015). Conclusion Sigmoid colon cancer patients with BMI ≥ 25 kg/m2 are the most appropriate candidates for postoperative TDT insertion, in terms of reduced incidence of AL and improved prognosis.https://doi.org/10.1002/ags3.12634anastomotic leakageinverse probability of treatment weightingsigmoid colon cancertrans‐anal tube |
| spellingShingle | Tetsuro Tominaga Takashi Nonaka Toshio Shiraishi Hiroshi Yano Shuntaro Sato Akiko Fukuda Makoto Hisanaga Shintaro Hashimoto Terumitsu Sawai Takeshi Nagayasu Impacts of trans‐anal tube placement in patients with sigmoid colon cancer: Risk verification analysis using inverse probability weighting analysis Annals of Gastroenterological Surgery anastomotic leakage inverse probability of treatment weighting sigmoid colon cancer trans‐anal tube |
| title | Impacts of trans‐anal tube placement in patients with sigmoid colon cancer: Risk verification analysis using inverse probability weighting analysis |
| title_full | Impacts of trans‐anal tube placement in patients with sigmoid colon cancer: Risk verification analysis using inverse probability weighting analysis |
| title_fullStr | Impacts of trans‐anal tube placement in patients with sigmoid colon cancer: Risk verification analysis using inverse probability weighting analysis |
| title_full_unstemmed | Impacts of trans‐anal tube placement in patients with sigmoid colon cancer: Risk verification analysis using inverse probability weighting analysis |
| title_short | Impacts of trans‐anal tube placement in patients with sigmoid colon cancer: Risk verification analysis using inverse probability weighting analysis |
| title_sort | impacts of trans anal tube placement in patients with sigmoid colon cancer risk verification analysis using inverse probability weighting analysis |
| topic | anastomotic leakage inverse probability of treatment weighting sigmoid colon cancer trans‐anal tube |
| url | https://doi.org/10.1002/ags3.12634 |
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