Luo Yun, Zhu Chang-Kang, Wu Ding-Quan, Zhou Liang-Bi, Wang Chong-Shu
Department of General Surgery, Beibei Traditional Chinese Medical Hospital, Chongqing, China.
Department of Surgery, Colorectal Cancer Center, Nanchong Oriental Hospital, Nanchong, Sichuan Province, China.
BMC Surg. 2020 Jul 25;20(1):166. doi: 10.1186/s12893-020-00811-x.
Anastomotic leakage (AL) is one of the most severe early complications after rectal cancer surgery. Many studies and meta-analysis results show that the indentation of transanal drainage tubes (TDT) can prevent and reduce the incidence of AL. However, the size and material of drainage tubes are rarely reported. Herein, we compare the effect of three kinds of TDT and analyze the use of TDT material and size to prevent AL, which may better prevent the occurrence of AL.
The clinical data of 182 patients who underwent laparoscopic anterior resection of rectal cancer were retrospectively analyzed between January 2016 and March 2019. According to the types of indwelling TDT after the operation, they were divided into Fr32 silicone tubes (81 cases), Fr24 silicone tubes (54 cases), Fr24 latex tubes (47 cases). The first drainage, exhaust, defecation, abdominal distension and anastomotic leakage of the patients with three different types of TDT were compared.
There was no significant difference in the degree of first exhaust, abdominal distension and anastomotic leakage among three different types of TDT; the time of first drainage and defecation of the Fr32 silicone tube was significantly earlier than that of Fr24 silicone tube and Fr24 latex tube.
The drainage effect of the Fr32 silicone tube is better than that of Fr24 silicone tube and Fr24 latex tube after anterior resection for rectal cancer, Fr32 silicone may better prevent the occurrence of AL, but randomized controlled studies are needed.
吻合口漏(AL)是直肠癌手术后最严重的早期并发症之一。许多研究和荟萃分析结果表明,经肛门引流管(TDT)的置入可预防并降低AL的发生率。然而,引流管的尺寸和材料鲜有报道。在此,我们比较三种TDT的效果,并分析TDT材料和尺寸对预防AL的作用,这可能会更好地预防AL的发生。
回顾性分析2016年1月至2019年3月期间182例行腹腔镜直肠癌前切除术患者的临床资料。根据术后留置TDT的类型,将患者分为Fr32硅胶管组(81例)、Fr24硅胶管组(54例)、Fr24乳胶管组(47例)。比较三种不同类型TDT患者的首次引流、排气、排便、腹胀及吻合口漏情况。
三种不同类型TDT在首次排气、腹胀及吻合口漏程度方面无显著差异;Fr32硅胶管的首次引流和排便时间显著早于Fr24硅胶管和Fr24乳胶管。
直肠癌前切除术后Fr32硅胶管的引流效果优于Fr24硅胶管和Fr24乳胶管;Fr32硅胶管可能能更好地预防AL的发生,但仍需进行随机对照研究。