Application of solid food diet combined with intermittent irrigation of abdominal drainage tube in the treatment of anastomotic leakage for rectal cancer

doi:10.3877/cma.j.issn.2095-3224.2021.05.016

Abstract

Abstract:

Objective

To investigate the effect and application of solid food diet combined with intermittent irrigation of abdominal drainage tube in the treatment of anastomotic leakage after rectal cancer surgery.

Methods

A retrospective study was performed to collect the data of patients who underwent radical resection of rectal cancer (Dixon) in the Second Affiliated Hospital of Nanjing Medical University from January 2015 to September 2018. Silica gel drainage tube and rubber drainage tube were positioned in dorsal side of anastomotic stoma during the operation. Patients with anastomotic leakage after operation were treated with solid food diet and intermittent flushing of abdominal drainage tube and the curative effect was observed.

Results

Among 152 patients who underwent radical resection of rectal cancer (Dixon), fourteen patients suffered from anastomotic leakage. Two patients received reoperation. One patient underwent terminal ileostomy and one patient underwent colostomy. Twelve patients were cured by solid food diet combined with intermittent flushing of abdominal drainage tube.

Conclusion

Solid food diet combined with intermittent flushing of abdominal drainage tube can improve the surrounding environment of anastomotic leakage and promote the healing of anastomotic leakage.

Key words: Rectal neoplasms, Anastomotic leakage, Solid food diet, Abdominal drainage

Xiagang Luo, Chen Lu, Xiang Ma, Ming Lu, Jian Shen, Xiaogang Dong, Fei Zhou, Qinghong Zhao, Jianping Zhang, Chunzhao Yu. Application of solid food diet combined with intermittent irrigation of abdominal drainage tube in the treatment of anastomotic leakage for rectal cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2021, 10(05): 536-540.

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https://zhjzcjbdzzz.cma-cmc.com.cn/EN/Y2021/V10/I05/536

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References 30

[1]	Keller DS, Berho M, Perez RO, et al. The multidisciplinary management of rectal cancer[J]. Nat Rev Gastroenterol Hepatol, 2020, 17(7): 414-429.
[2]	O'Connell EP, Healy V, Fitzpatrick F, et al. Predictors of readmission following proctectomy for rectal cancer[J]. Dis Colon Rectum, 2019, 62(6): 703-710.
[3]	中华医学会外科学分会结直肠外科学组. 中国直肠癌手术吻合口漏诊断、预防及处理专家共识(2019版)[J]. 中华胃肠外科杂志, 2019, 22(3): 201-206.
[4]	Rahbari NN, Weitz J, Hohenberger W, et al. Definition and grading of anastomotic leakage following anterior resection of the rectum: a proposal by the International Study Group of Rectal Cancer[J]. Surgery, 2010, 147(3): 339-351.
[5]	Wang S, Liu J, Wang S, et al. Adverse effects of anastomotic leakage on local recurrence and survival after curative anterior resection for rectal cancer: a systematic review and meta-analysis[J]. World J Surg, 2017, 41(1): 277-284.
[6]	Kang CY, Halabi WJ, Chaudhry OO, et al. Risk factors for anastomotic leakage after anterior resection for rectal cancer[J]. JAMA Surg, 2013, 148(1): 65-71.
[7]	Ashraf SQ, Burns EM, Jani A, et al. The economic impact of anastomotic leakage after anterior resections in English NHS hospitals: are we adequately remunerating them?[J]. Colorectal Dis, 2013, 15(4): e190-e198.
[8]	Bostrom P, Haapamaki MM, Rutegard J, et al. Population-based cohort study of the impact on postoperative mortality of anastomotic leakage after anterior resection for rectal cancer[J]. BJS Open, 2019, 3(1): 106-111.
[9]	吴红杰, 邹小明.结直肠癌术后吻合口瘘的诊治及预防[J/CD].中华结直肠疾病电子杂志, 2016, 5(2): 171-174.
[10]	Chi P, Huang S. Anastomotic leakage after rectal cancer surgery: classification and management[J]. Chin J Gastrointest Surg, 2018, 21(4): 365-371.
[11]	Matthiessen P, Hallbook O, Rutegard J, et al. Defunctioning stoma reduces symptomatic anastomotic leakage after low anterior resection of the rectum for cancer: a randomized multicenter trial[J]. Ann Surg, 2007, 246(2): 207-214.
[12]	Frasson M, Flor-Lorente B, Rodriguez J L, et al. Risk factors for anastomotic leak after colon resection for cancer: multivariate analysis and nomogram from a multicentric, prospective, national study with 3 193 patients[J]. Ann Surg, 2015, 262(2): 321-330.
[13]	Leichtle SW, Mouawad NJ, Welch KB, et al. Risk factors for anastomotic leakage after colectomy[J]. Dis Colon Rectum, 2012, 55(5): 569-575.
[14]	赵海剑, 平洪, 王健, 等. 肠内营养联合双套管治疗直肠癌术后吻合口漏的疗效观察[J/CD]. 中华结直肠疾病电子杂志, 2017, 6(2): 144-146.
[15]	Luo Y, Zhu CK, Wu DQ, et al. Effect comparison of three different types of transanal drainage tubes after anterior resection for rectal cancer[J]. BMC Surg, 2020, 20(1): 166.
[16]	Wang Z, Liang J, Chen J, et al. Effectiveness of a transanal drainage tube for the prevention of anastomotic leakage after laparoscopic low anterior resection for rectal cancer[J]. Asian Pac J Cancer Prev, 2020, 21(5): 1441-1444.
[17]	Wang S, Zhang Z, Liu M, et al. Efficacy of transanal tube placement after anterior resection for rectal cancer: a systematic review and meta-analysis[J]. World J Surg Oncol, 2016, 14: 92.
[18]	Tamura K, Matsuda K, Horiuchi T, et al. Laparoscopic anterior resection with or without transanal tube for rectal cancer patients - A multicenter randomized controlled trial[J]. Am J Surg, 2021, 222(3): 606-612.
[19]	Denost Q, Rouanet P, Faucheron JL, et al. To drain or not to drain infraperitoneal anastomosis after rectal excision for cancer: the GRECCAR 5 randomized trial[J]. Ann Surg, 2017, 265(3): 474-480.
[20]	Placer C. Comment on "to drain or not to drain infraperitoneal anastomosis after rectal excision for cancer: an unclosed debate"[J]. Ann Surg, 2019, 270(2): e23-e24.
[21]	Escrig-Sos J, Llueca-Abella A. To drain or not to drain the infraperitoneal anastomosis after rectal excision for cancer[J]. Cir Esp, 2017, 95(7): 414-415.
[22]	Rondelli F, Bugiantella W, Vedovati MC, et al. To drain or not to drain extraperitoneal colorectal anastomosis? A systematic review and meta-analysis[J]. Colorectal Dis, 2014, 16(2): O35-O42.
[23]	Samaiya A. To drain or not to drain after colorectal cancer surgery[J]. Indian J Surg, 2015, 77(Suppl 3): 1363-1368.
[24]	伍晓汀, 周勇. 腹腔引流管的正确选择和合理应用[J]. 中国实用外科杂志, 2005, 25(1): 35-36.
[25]	Warren J, Bhalla V, Cresci G. Postoperative diet advancement: surgical dogma vs evidence-based medicine[J]. Nutr Clin Pract, 2011, 26(2): 115-125.
[26]	高亚妮, 芦桂芝, 林竹, 等. 结直肠癌术后肠内营养与肠外营养有效性、安全性的Meta分析[J]. 胃肠病学和肝病学杂志, 2020, 29(3): 309-317.
[27]	Boelens PG, Heesakkers FF, Luyer MD, et al. Reduction of postoperative ileus by early enteral nutrition in patients undergoing major rectal surgery: prospective, randomized, controlled trial[J]. Ann Surg, 2014, 259(4): 649-655.
[28]	Peters EG, Smeets BJ, Dekkers M, et al. The effects of stimulation of the autonomic nervous system via perioperative nutrition on postoperative ileus and anastomotic leakage following colorectal surgery (SANICS Ⅱ trial): a study protocol for a double-blind randomized controlled trial[J]. Trials, 2015, 16: 20.
[29]	史媛, 董贝贝, 谢克亮, 等. 半固体食物用于硬膜外分娩镇痛产妇能量补充的效果[J]. 中华麻醉学杂志, 2020, 40(7): 855-858.
[30]	蒋奕, 吴国豪, 韩寓嵩, 等. 长期肠外营养的合理应用与并发症防治[J]. 中华外科杂志, 2014, 52(9): 709-713.

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