Efficacy of transanal drainage for anal function and quality-of-life in patients of colorectal anastomotic leakage
Objective To explore the clinical efficacy of transanal anastomotic drainage for colorectal anastomotic leakage and examine its impact on anal function and quality-of-life.Methods From January 1,2007 to December 31,2023,the relevant clinical data were retrospectively reviewed for 1 016 patients undergoing colorectal anastomosis.Postoperative anastomotic leakage occurred in 218 patients and colostomy was repeated in 15 patients due to severe abdominal infection and diffuse peritonitis.And 115 patients of anastomotic leakage improved after conservative measures and 10 cases could not be followed up due to missing data.Finally the relevant clinical data were retrospectively reviewed for 78 patients of anastomotic leakage.They were assigned into two groups of transanal drainage(study,n1=18)and simple transabdominal drainage(control,n=60).They were examined by assessment scales of low anterior resection syndrome(LARS)and Wexner fecal incontinence and European Organization for Research and Treatment of Cancer(EORTC).And EORTC Quality-of-Life Scale(EORTC QLQ-C30)was employed for assessing postoperative quality-of-life and anal function.Results After colorectal operation,78 patients of anastomotic leakage were cured and discharged from hospital.No obvious diffuse peritonitis or abdominal infection occurred.Both groups were followed up for 3 months post-discharge.There was no recurrence of tumor,anastomotic stenosis or scar hyperplasia.Anal function:As compared with control group,the scores of LARS[(20.28±9.95)vs.(25.55±11.71)points]and Wexner[(10.56±2.36)vs.(13.00±2.52)points]were lower in study group pre-catheterization and the differences were statistically significant(all P＜0.05).However,there was no significant inter-group difference post-catheterization(all P＞0.05).EORTC QLQ-C30 quality-of-life:Prior to catheterization,study group demonstrated worse performance in the domains of role function,social function and respiratory symptoms than those in control group.And the differences were statistically significant(all P＜0.05).However,no significant inter-group difference existed in EORTC QLQ-C30 score post-catheterization(all P＞0.05).Conclusion Catheter irrigation and drainage through anal anastomotic leakage may be an important treatment for patients of anastomotic leakage after colorectal surgery.As anal function is restored after surgery,quality-of-life improves,rate of anastomotic stenosis drops and the chance of a second stomy is minimized.This safe treatment is worthy of wider clinical applications.
ColorectalAnastomotic leakageCatheterization through anal fistulaAnal functionQuality-of-life
万方数据
维普
