Evidence map›Paper›PMID 38916755›Full record

SynthesisTechniques in coloproctology2024

Updated evidence of the effectiveness and safety of transanal drainage tube for the prevention of anastomotic leakage after rectal low anterior resection: a systematic review and meta-analysis.

K Tamura, M Uchino, S Nomura, S Shinji, K Kouzu, T Fujimoto, K Nagayoshi, Y Mizuuchi, H Ohge, S Haji and 13 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Techniques in coloproctology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
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  10. FromIndian journal of surgical oncology · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

K TamuraDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Fukuoka, 812-8582, Japan. tamura.koji.589@m.kyushu-u.ac.jp.ORCID 0000-0003-2500-8810
M UchinoDivision of Inflammatory Bowel Disease, Department of Gastroenterological Surgery, Hyogo Medical University, Hyogo, Japan.
S NomuraDepartment of Surgery, Hayamizu-Park Clinic, Miyazaki, Japan.
S ShinjiDepartment of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan.
K KouzuDepartment of Surgery, National Defence Medical College, Saitama, Japan.
T FujimotoDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Fukuoka, 812-8582, Japan.
K NagayoshiDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Fukuoka, 812-8582, Japan.
Y MizuuchiDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Fukuoka, 812-8582, Japan.
H OhgeDepartment of Infectious Disease, Hiroshima University Hospital, Hiroshima, Japan.
S HajiDepartment of Surgery, Soseikai General Hospital, Kyoto, Japan.
J ShimizuDepartment of Surgery, Toyonaka Municipal Hospital, Osaka, Japan.
Y MohriDepartment of Gastrointestinal Surgery, Mie Prefectural General Medical Center, Mie, Japan.
C YamashitaDepartment of Anesthesiology and Critical Care Medicine, Fujita Health University, Aichi, Japan.
Y KitagawaDepartment of Gastrointestinal Surgery, National Center for Geriatrics and Gerontology, Aichi, Japan.
K SuzukiDepartment of Infectious Disease Medicine, University of Occupational and Environmental Health, Fukuoka, Japan.
M KobayashiDepartment of Anesthesiology, Hokushinkai Megumino Hospital, Hokkaido, Japan.
M KobayashiDepartment of Clinical Pharmacokinetics, Research and Education Center for Clinical Pharmacy, Kitasato University, Kanagawa, Japan.
M YoshidaDepartment of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, School of Medicine, International University of Health and Welfare, Chiba, Japan.
T MizuguchiDepartment of Nursing, Surgical Sciences, Sapporo Medical University, Hokkaido, Japan.
T MayumiDepartment of Intensive Care Unit, Japan Community Health Care Organization Chukyo Hospital, Aichi, Japan.
Y KitagawaSchool of Medicine, Keio University, Tokyo, Japan.
M NakamuraDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Fukuoka, 812-8582, Japan. nakamura.masafumi.861@m.kyushu-u.ac.jp.
guideline committee for the prevention, detection, and management of gastroenterological surgical site infections in Japan Society for Surgical Infection

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundsAnastomotic leakage (AL) represents a major complication after rectal low anterior resection (LAR). Transanal drainage tube (TDT) placement offers a potential strategy for AL prevention; however, its efficacy and safety remain contentious.

methodsA systematic review and meta-analysis were used to evaluate the influence of TDT subsequent to LAR as part of the revision of the surgical site infection prevention guidelines of the Japanese Society of Surgical Infectious Diseases (PROSPERO registration; CRD42023476655). We searched each database, and included randomized controlled trials (RCTs) and observational studies (OBSs) comparing TDT and non-TDT outcomes. The main outcome was AL. Data were independently extracted by three authors and random-effects models were implemented.

resultsA total of three RCTs and 18 OBSs were included. RCTs reported no significant difference in AL rate between the TDT and non-TDT groups [relative risk (RR): 0.69, 95% confidence interval (CI) 0.42-1.15]. OBSs reported that TDT reduced AL risk [odds ratio (OR): 0.45, 95% CI 0.31-0.64]. In the subgroup excluding diverting stoma (DS), TDT significantly lowered the AL rate in RCTs (RR: 0.57, 95% CI 0.33-0.99) and OBSs (OR: 0.41, 95% CI 0.27-0.62). Reoperation rates were significantly lower in the TDT without DS groups in both RCTs (RR: 0.26, 95% CI 0.07-0.94) and OBSs (OR: 0.40, 95% CI 0.24-0.66). TDT groups exhibited a higher anastomotic bleeding rate only in RCTs (RR: 4.28, 95% CI 2.14-8.54), while shorter hospital stays were observed in RCTs [standard mean difference (SMD): -0.44, 95% CI -0.65 to -0.23] and OBSs (SMD: -0.54, 95% CI -0.97 to -0.11) compared with the non-TDT group.

conclusionsA universal TDT placement cannot be recommended for all rectal LAR patients. Some patients may benefit from TDT, such as patients without DS creation. Further investigation is necessary to identify the specific beneficiaries.

Indexed as

Anal CanalAnastomotic LeakDrainageProctectomyRandomized Controlled Trials as TopicRectumFemaleHumansMaleMiddle AgedObservational Studies as TopicRectal NeoplasmsTreatment OutcomeAnastomotic leakageColorectal surgeryRectal cancerSurgical site infectionTransanal drainage

Identifiers

PMID38916755

What OpenQuestion holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.