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An updated meta-analysis of transanal drainage tube for prevention of anastomotic leak in anterior resection for rectal cancer
Anastomotic leakage (AL) is one of the most serious complications after anterior resection for rectal cancer. Transanal drainage tube (TDT) placement is widely used to reduce AL, but its efficacy remains controversial. We performed a meta-analysis to evaluate the effectiveness of TDT for prevention...
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| Published in: | Surgical oncology 2018-09, Vol.27 (3), p.333-340 |
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| Language: | English |
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| creator | Chen, Hong Cai, Hong-Ke Tang, Yun-Hao |
| description | Anastomotic leakage (AL) is one of the most serious complications after anterior resection for rectal cancer. Transanal drainage tube (TDT) placement is widely used to reduce AL, but its efficacy remains controversial. We performed a meta-analysis to evaluate the effectiveness of TDT for prevention of AL, using updated evidence.
Randomized controlled trials (RCTs) and cohort studies evaluating the effectiveness of TDT for prevention of AL after anterior resection for rectal cancer were identified by using a predefined search strategy. Meta-analysis was performed to estimate the pooled rates of AL, reoperation, anastomotic bleeding and mortality separately.
One RCT and ten cohort studies which including 1170 cases with TDT and 1262 cases without TDT were considered eligible for inclusion. Meta-analysis showed that the TDT group was associated with a significant lower rates of AL (RR: 0.42, 95% CI: 0.31–0.58, P |
| doi_str_mv | 10.1016/j.suronc.2018.05.018 |
| format | article |
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Randomized controlled trials (RCTs) and cohort studies evaluating the effectiveness of TDT for prevention of AL after anterior resection for rectal cancer were identified by using a predefined search strategy. Meta-analysis was performed to estimate the pooled rates of AL, reoperation, anastomotic bleeding and mortality separately.
One RCT and ten cohort studies which including 1170 cases with TDT and 1262 cases without TDT were considered eligible for inclusion. Meta-analysis showed that the TDT group was associated with a significant lower rates of AL (RR: 0.42, 95% CI: 0.31–0.58, P < 0.00001) and reoperation (RR: 0.29, 95% CI: 0.19–0.45, P < 0.00001). There was no significant difference in anastomotic bleeding rate and mortality between the two groups.
TDT placement is associated with significant lower rates of AL and reoperation, hence it is likely to be an effective method of preventing and reducing AL after rectal cancer surgery.</description><identifier>ISSN: 0960-7404</identifier><identifier>EISSN: 1879-3320</identifier><identifier>DOI: 10.1016/j.suronc.2018.05.018</identifier><identifier>PMID: 30217286</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Anal Canal - surgery ; Anastomotic Leak - etiology ; Anastomotic Leak - prevention & control ; Anastomotic leakage ; Anterior resection ; Bleeding ; Cancer ; Colorectal cancer ; Complications ; Control methods ; Digestive System Surgical Procedures - adverse effects ; DNA nucleotidylexotransferase ; Drainage - methods ; Gender ; Humans ; Meta-analysis ; Mortality ; Ostomy ; Placement ; Postoperative Complications - prevention & control ; Prevention ; Rectal Neoplasms - surgery ; Rectum ; Studies ; Surgery ; Transanal drainage tube</subject><ispartof>Surgical oncology, 2018-09, Vol.27 (3), p.333-340</ispartof><rights>2018 Elsevier Ltd</rights><rights>Copyright © 2018 Elsevier Ltd. All rights reserved.</rights><rights>Copyright Elsevier Limited Sep 2018</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c390t-c6f2e0edf49f5141cb1fb873cfaef3ef1f368b8dd06cc527cd8488cf7d8c2a243</citedby><cites>FETCH-LOGICAL-c390t-c6f2e0edf49f5141cb1fb873cfaef3ef1f368b8dd06cc527cd8488cf7d8c2a243</cites><orcidid>0000-0001-9878-1826</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30217286$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, Hong</creatorcontrib><creatorcontrib>Cai, Hong-Ke</creatorcontrib><creatorcontrib>Tang, Yun-Hao</creatorcontrib><title>An updated meta-analysis of transanal drainage tube for prevention of anastomotic leak in anterior resection for rectal cancer</title><title>Surgical oncology</title><addtitle>Surg Oncol</addtitle><description>Anastomotic leakage (AL) is one of the most serious complications after anterior resection for rectal cancer. Transanal drainage tube (TDT) placement is widely used to reduce AL, but its efficacy remains controversial. We performed a meta-analysis to evaluate the effectiveness of TDT for prevention of AL, using updated evidence.
Randomized controlled trials (RCTs) and cohort studies evaluating the effectiveness of TDT for prevention of AL after anterior resection for rectal cancer were identified by using a predefined search strategy. Meta-analysis was performed to estimate the pooled rates of AL, reoperation, anastomotic bleeding and mortality separately.
One RCT and ten cohort studies which including 1170 cases with TDT and 1262 cases without TDT were considered eligible for inclusion. Meta-analysis showed that the TDT group was associated with a significant lower rates of AL (RR: 0.42, 95% CI: 0.31–0.58, P < 0.00001) and reoperation (RR: 0.29, 95% CI: 0.19–0.45, P < 0.00001). There was no significant difference in anastomotic bleeding rate and mortality between the two groups.
TDT placement is associated with significant lower rates of AL and reoperation, hence it is likely to be an effective method of preventing and reducing AL after rectal cancer surgery.</description><subject>Anal Canal - surgery</subject><subject>Anastomotic Leak - etiology</subject><subject>Anastomotic Leak - prevention & control</subject><subject>Anastomotic leakage</subject><subject>Anterior resection</subject><subject>Bleeding</subject><subject>Cancer</subject><subject>Colorectal cancer</subject><subject>Complications</subject><subject>Control methods</subject><subject>Digestive System Surgical Procedures - adverse effects</subject><subject>DNA nucleotidylexotransferase</subject><subject>Drainage - methods</subject><subject>Gender</subject><subject>Humans</subject><subject>Meta-analysis</subject><subject>Mortality</subject><subject>Ostomy</subject><subject>Placement</subject><subject>Postoperative Complications - prevention & control</subject><subject>Prevention</subject><subject>Rectal Neoplasms - surgery</subject><subject>Rectum</subject><subject>Studies</subject><subject>Surgery</subject><subject>Transanal drainage tube</subject><issn>0960-7404</issn><issn>1879-3320</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9kU-LFDEQxYMo7rj6DUQCXrx0W0n6T-YiLIu6woIXPYd0UpGM3cmYpBf24mc3PbN68LCnRxW_egXvEfKaQcuADe8PbV5TDKblwGQLfVvlCdkxOe4bITg8JTvYD9CMHXQX5EXOBwAYRs6ekwsBnI1cDjvy-yrQ9Wh1QUsXLLrRQc_32WcaHS1Jh7wtqE3aB_0DaVknpC4mekx4h6H4GDayQrnEJRZv6Iz6J_Wh7gomX9GEGc2JdKfJlOpodDCYXpJnTs8ZXz3oJfn-6eO365vm9uvnL9dXt40ReyiNGRxHQOu6vetZx8zE3CRHYZxGJ9AxJwY5SWthMKbno7Gyk9K40UrDNe_EJXl39j2m-GvFXNTis8F51gHjmhVn0EPXSyEq-vY_9BDXVEM4UVx0TABUqjtTJsWcEzp1TH7R6V4xUFs_6qDO_aitHwW9qlLP3jyYr9OC9t_R30Iq8OEMYE3jzmNS2XisUVm_Bads9I9_-AOYZ6Xz</recordid><startdate>20180901</startdate><enddate>20180901</enddate><creator>Chen, Hong</creator><creator>Cai, Hong-Ke</creator><creator>Tang, Yun-Hao</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9878-1826</orcidid></search><sort><creationdate>20180901</creationdate><title>An updated meta-analysis of transanal drainage tube for prevention of anastomotic leak in anterior resection for rectal cancer</title><author>Chen, Hong ; Cai, Hong-Ke ; Tang, Yun-Hao</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c390t-c6f2e0edf49f5141cb1fb873cfaef3ef1f368b8dd06cc527cd8488cf7d8c2a243</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Anal Canal - surgery</topic><topic>Anastomotic Leak - etiology</topic><topic>Anastomotic Leak - prevention & control</topic><topic>Anastomotic leakage</topic><topic>Anterior resection</topic><topic>Bleeding</topic><topic>Cancer</topic><topic>Colorectal cancer</topic><topic>Complications</topic><topic>Control methods</topic><topic>Digestive System Surgical Procedures - adverse effects</topic><topic>DNA nucleotidylexotransferase</topic><topic>Drainage - methods</topic><topic>Gender</topic><topic>Humans</topic><topic>Meta-analysis</topic><topic>Mortality</topic><topic>Ostomy</topic><topic>Placement</topic><topic>Postoperative Complications - prevention & control</topic><topic>Prevention</topic><topic>Rectal Neoplasms - surgery</topic><topic>Rectum</topic><topic>Studies</topic><topic>Surgery</topic><topic>Transanal drainage tube</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Hong</creatorcontrib><creatorcontrib>Cai, Hong-Ke</creatorcontrib><creatorcontrib>Tang, Yun-Hao</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Hong</au><au>Cai, Hong-Ke</au><au>Tang, Yun-Hao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>An updated meta-analysis of transanal drainage tube for prevention of anastomotic leak in anterior resection for rectal cancer</atitle><jtitle>Surgical oncology</jtitle><addtitle>Surg Oncol</addtitle><date>2018-09-01</date><risdate>2018</risdate><volume>27</volume><issue>3</issue><spage>333</spage><epage>340</epage><pages>333-340</pages><issn>0960-7404</issn><eissn>1879-3320</eissn><abstract>Anastomotic leakage (AL) is one of the most serious complications after anterior resection for rectal cancer. Transanal drainage tube (TDT) placement is widely used to reduce AL, but its efficacy remains controversial. We performed a meta-analysis to evaluate the effectiveness of TDT for prevention of AL, using updated evidence.
Randomized controlled trials (RCTs) and cohort studies evaluating the effectiveness of TDT for prevention of AL after anterior resection for rectal cancer were identified by using a predefined search strategy. Meta-analysis was performed to estimate the pooled rates of AL, reoperation, anastomotic bleeding and mortality separately.
One RCT and ten cohort studies which including 1170 cases with TDT and 1262 cases without TDT were considered eligible for inclusion. Meta-analysis showed that the TDT group was associated with a significant lower rates of AL (RR: 0.42, 95% CI: 0.31–0.58, P < 0.00001) and reoperation (RR: 0.29, 95% CI: 0.19–0.45, P < 0.00001). There was no significant difference in anastomotic bleeding rate and mortality between the two groups.
TDT placement is associated with significant lower rates of AL and reoperation, hence it is likely to be an effective method of preventing and reducing AL after rectal cancer surgery.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>30217286</pmid><doi>10.1016/j.suronc.2018.05.018</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-9878-1826</orcidid></addata></record> |
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| language | eng |
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| source | Elsevier |
| subjects | Anal Canal - surgery Anastomotic Leak - etiology Anastomotic Leak - prevention & control Anastomotic leakage Anterior resection Bleeding Cancer Colorectal cancer Complications Control methods Digestive System Surgical Procedures - adverse effects DNA nucleotidylexotransferase Drainage - methods Gender Humans Meta-analysis Mortality Ostomy Placement Postoperative Complications - prevention & control Prevention Rectal Neoplasms - surgery Rectum Studies Surgery Transanal drainage tube |
| title | An updated meta-analysis of transanal drainage tube for prevention of anastomotic leak in anterior resection for rectal cancer |
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