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Transanal drainage tube for the prevention of anastomotic leakage after rectal cancer surgery: a meta−analysis of randomized controlled trials

BACKGROUND: Anastomotic 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) t...

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Autores principales: Xia, Shijun, Wu, Wenjiang, Ma, Lijuan, Luo, Lidan, Yu, Linchong, Li, Yue
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10235681/
https://www.ncbi.nlm.nih.gov/pubmed/37274258
http://dx.doi.org/10.3389/fonc.2023.1198549
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author Xia, Shijun
Wu, Wenjiang
Ma, Lijuan
Luo, Lidan
Yu, Linchong
Li, Yue
author_facet Xia, Shijun
Wu, Wenjiang
Ma, Lijuan
Luo, Lidan
Yu, Linchong
Li, Yue
author_sort Xia, Shijun
collection PubMed
description BACKGROUND: Anastomotic 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. METHODS: Relevant 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. RESULTS: This 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). CONCLUSION: TDT 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.
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spelling pubmed-102356812023-06-03 Transanal drainage tube for the prevention of anastomotic leakage after rectal cancer surgery: a meta−analysis of randomized controlled trials Xia, Shijun Wu, Wenjiang Ma, Lijuan Luo, Lidan Yu, Linchong Li, Yue Front Oncol Oncology BACKGROUND: Anastomotic 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. METHODS: Relevant 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. RESULTS: This 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). CONCLUSION: TDT 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. Frontiers Media S.A. 2023-05-19 /pmc/articles/PMC10235681/ /pubmed/37274258 http://dx.doi.org/10.3389/fonc.2023.1198549 Text en Copyright © 2023 Xia, Wu, Ma, Luo, Yu and Li https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Xia, Shijun
Wu, Wenjiang
Ma, Lijuan
Luo, Lidan
Yu, Linchong
Li, Yue
Transanal drainage tube for the prevention of anastomotic leakage after rectal cancer surgery: a meta−analysis of randomized controlled trials
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 Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10235681/
https://www.ncbi.nlm.nih.gov/pubmed/37274258
http://dx.doi.org/10.3389/fonc.2023.1198549
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