Application of the cuff rectum drainage tube in total mesorectal excision for low rectal cancer

Abstract

To investigate therapeutic effect of cuff rectum drainage tube (CDT) in preventing the postoperative complications of total mesorectal excision (TME) and promoting the recovery of the patients. The clinical data of 84 cases of low rectal cancer performed TME from June 2015 to June 2017 in the First Affiliated Hospital of Xiamen University were analyzed retrospectively. All the cases were performed anus-retained operation without preventive colostomy. Patients were divided into 2 groups according to the material of the anorectal drainage tube placed in the colonic cavity. Group I (CDT group) was transanal cuff rectal drainage tube placement (Patent No. ZL 201320384337.8) (n = 48), and group II (conventional group) was transanal clinical conventional drainage tube placement (n = 36). Anastomotic fistula incidence, the time of anal exsufflation, postoperative first ambulation time, intestinal function recovery time, the incidence of interrelated complications of drainage tube and postoperative hospital stay between 2 groups were analyzed retrospectively. Both postoperative first ambulation and anal exhaust time in CDT group were shorter than those in the conventional group ([2.3 ± 0.4] d vs [3.0 ± 0.2] d, P < .05; [3.3 ± 0.3] d vs [3.9 ± 0.5] d, P < .05). Meanwhile, the postoperative hospital stay of CDT group was significantly decreased than that in the conventional group ([10.3 ± 1.6] d vs [11.8 ± 1.1] d, P < .05). Significant different occurrence of complications existed in anastomotic fistula (2.1% [1/48] vs 16.7% [6/36], P < .05), frequent defecation (8.3% [4/48] vs 27.8% [10/36], P < .05), defecating unfinished feeling (12.5% [6/48] vs 30.6% [11/36], P < .05), drainage tube complication (4.2% [2/48] vs 22.2% [8/36], P < .05). The cuff rectum drainage tube may reduce incidence of anastomotic fistula after TME, shorten postoperative first ambulation and anal exsufflation time, enable faster recovery with good toleration and decrease postoperative hospital stay.

No Coil® placement in patients undergoing left hemicolectomy and low anterior resection for colorectal cancer

“…Nevertheless, this procedure is burdened by several complications (e.g., longer hospital stay, reversal procedure, greater inpatient costs, permanent stoma, stoma-related complications, and patient discomfort) [ 14 , 15 ]. Given the evidence that increased intraluminal rectal pressure is among the major contributors to AL [ 16 – 19 ], several endorectal devices (e.g., transanal tube cuff rectum, drainage tube, silicone transanal tube) have been proposed as promising alternatives to defunctioning stoma [ 13 , 20 , 21 ].…”

Is the preservation of the left colic artery an ideal choice for colorectal cancer surgery? A meta-analysis

“…The conservation of the LCA would decrease the mobility of the proximal intestine by approximately 6-9 cm, which could increase the tension of the anastomotic stoma [50,51], and this may balance out the bene t of better blood supply. Besides, a protective stoma of the distal ileum was more common in radical surgery for mid-low RC, which would also in uence the diagnosis of anastomosis leakage [52]. To our knowledge, the balance between better perfusion provided by LCA preservation and the less tension of the colon limb proximal to the anastomotic stoma with LCA ligation should be determined by the location of the cancer and be evaluated according to the intraoperative circumstance of each case.…”

Anastomotic Leak Rate and Prolonged Postoperative Paralytic Ileus in Patients Undergoing Laparoscopic Surgery for Colo-Rectal Cancer After Placement of No-Coil Endoanal Tube

“…11,12 According to the physiological concept that the increase of endorectal pressure can cause AL, 10 the use of endorectal devices (e.g., trans-anal tube cuff rectum, drainage tube, and silicone trans-anal tube) has increased in recent years. [13][14][15][16][17] These products, described above, are able to reduce the endorectal pressure.…”