The presacral space as a collector of fluid accumulations following rectal anastomosis: tolerance of rectal anastomosis to closed suction pelvic drainage.

The amounts of fluid that collect in the presacral space after rectal anastomosis were measured in 88 such patients (85 one-stage, three two-stage) treated by one surgeon with closed suction presacral space drainage. Fluid accumulations ranged from 0 to 1816 ml (mean 258 ml) and were not influenced by various factors studied. Only one patient developed an anastomotic leak, and one died postoperatively. None of the 82 patients followed one to five years and none of five patients lost to follow-up after five to 24 months experienced anastomotic complications. These data document the presacral space as a significant collector of fluids following such operations and do not support the concern that such a tube might damage or contaminate the anastomosis more than if left undrained when measured by increased rate of anastomotic leakage, by prolonged hospitalization, or by the appearance of anastomotic complications during the follow-up period.