ArticleTechniques in coloproctology2025
Role of transanal tube placement in preventing anastomotic leakage in rectal cancer surgery with sufficient perfusion confirmed by indocyanine green fluorescence imaging.
Article in Techniques in coloproctology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAnastomotic leakage (AL) remains a major complication after rectal cancer surgery. Although various techniques have been proposed to reduce its incidence, the effectiveness of transanal tube (TA) placement remains controversial. This study aimed to evaluate whether combining indocyanine green (ICG) fluorescence angiography with TA placement reduces the risk of AL after rectal cancer surgery.
methodsA retrospective analysis, including patients who underwent rectal resection with primary anastomosis for rectal cancer, was performed. In all cases, anastomotic perfusion was assessed intraoperatively using ICG fluorescence angiography. Patients were categorized into two groups on the basis of postoperative TA placement: TA group and non-TA group. The primary outcome was the incidence of AL. Multivariate logistic regression and subgroup analyses based on tumor location were performed.
resultsThe TA group demonstrated a significantly lower incidence of AL compared with the control group (5% versus 18%, p = 0.02). Multivariate analysis identified male sex as a risk factor and TA placement as a protective factor for AL. Subgroup analysis revealed that TA placement was particularly effective in patients with middle rectal cancer.
conclusionsThe placement of a TA may offer additional benefit in reducing the risk of AL after rectal cancer surgery when adequate perfusion is confirmed using ICG fluorescence imaging, particularly in cases of middle rectal cancer.
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