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<p>Anastomotic leakage is a serious complication after surgery for rectal cancer. The prevention of anastomotic leakage is important, and prevention methods include temporary ileostomy and transanal drainage tubes. In clinical practice, a TDT is often used in combination with a temporary ileostomy. Many studies have compared ileostomy and TDT; however, there are few reports on the additive effects of TDT in patients with temporary ileostomy. We included patients who underwent laparoscopic surgery for rectal cancer (cT1-2/N0/M0) located within 5&#xa0;cm of the anal verge at 47 specialized centers in Japan between 2014 and 2017. Gastrointestinal anastomosis was performed in the patients, and a temporary ileostomy was created. Eligible patients were matched 1:1 based on propensity scores for the presence or absence of TDT. Postoperative outcomes and complications were compared between TDT and non-TDT groups. Of 299 cases collected, 252 were eligible for inclusion. After propensity score matching, 166 patients (83 per group) were included. In the TDT group, there was a significant delay in urinary catheter removal (4.3 ± 0.3 vs. 3.5 ± 0.3&#xa0;days, P = 0.028) and prolonged hospital stay (20.2 ± 1.1 vs. 17.5 ± 1.1&#xa0;days, P = 0.027). However, there were no significant differences in the number of anastomotic leakages (grade I, 1 vs. 1; grade II, 2 vs. 1; and grade III, 2 vs. 2; P = 1.000) or other postoperative complications between the groups. In patients in which a temporary ileostomy is created during lower rectal cancer surgery, the need for TDT is considered insignificant.</p>

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Transanal drainage tube placement in patients with temporary ileostomy after laparoscopic rectal resection for rectal cancer

  • 期刊论文

  • 发表日期：

    2026年1月8日

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  • Nobuaki Hoshino,
  • Koya Hida,
  • Yuichiro Tsukada,
  • Kazutaka Obama,
  • Jun Watanabe,
  • Yosuke Fukunaga,
  • Yasumitsu Hirano,
  • Kazuhiro Sakamoto,
  • Hiroki Hamamoto,
  • Masanori Yoshimitsu,
  • Hisanaga Horie,
  • Nobuhisa Matsuhashi,
  • Yoshiaki Kuriu,
  • Shuntaro Nagai,
  • Madoka Hamada,
  • Shinichi Yoshioka,
  • Shinobu Ohnuma,
  • Tamuro Hayama,
  • Koki Otsuka,
  • Yusuke Inoue,
  • Kazuki Ueda,
  • Yuji Toiyama,
  • Satoshi Maruyama,
  • Shigeki Yamaguchi,
  • Keitaro Tanaka,
  • Motoko Suzuki,
  • Toshihiro Misumi,
  • Takeshi Naitoh,
  • Masahiko Watanabe,
  • Masaaki Ito

摘要

Anastomotic leakage is a serious complication after surgery for rectal cancer. The prevention of anastomotic leakage is important, and prevention methods include temporary ileostomy and transanal drainage tubes. In clinical practice, a TDT is often used in combination with a temporary ileostomy. Many studies have compared ileostomy and TDT; however, there are few reports on the additive effects of TDT in patients with temporary ileostomy. We included patients who underwent laparoscopic surgery for rectal cancer (cT1-2/N0/M0) located within 5 cm of the anal verge at 47 specialized centers in Japan between 2014 and 2017. Gastrointestinal anastomosis was performed in the patients, and a temporary ileostomy was created. Eligible patients were matched 1:1 based on propensity scores for the presence or absence of TDT. Postoperative outcomes and complications were compared between TDT and non-TDT groups. Of 299 cases collected, 252 were eligible for inclusion. After propensity score matching, 166 patients (83 per group) were included. In the TDT group, there was a significant delay in urinary catheter removal (4.3 ± 0.3 vs. 3.5 ± 0.3 days, P = 0.028) and prolonged hospital stay (20.2 ± 1.1 vs. 17.5 ± 1.1 days, P = 0.027). However, there were no significant differences in the number of anastomotic leakages (grade I, 1 vs. 1; grade II, 2 vs. 1; and grade III, 2 vs. 2; P = 1.000) or other postoperative complications between the groups. In patients in which a temporary ileostomy is created during lower rectal cancer surgery, the need for TDT is considered insignificant.