A double-lumen irrigation-suction tube placed during operation could reduce the risk of grade C anastomotic leakage resu
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ORIGINAL ARTICLE
A double-lumen irrigation-suction tube placed during operation could reduce the risk of grade C anastomotic leakage resulting from selective sigmoid colon cancer radical resection Fan Yang 1 & Dong Liu 2 & Xin Xu 3 & Weliang Tian 1 & Zheng Yao 3
&
Chaoyang Wang 4 & Risheng Zhao 3
Received: 3 May 2020 / Accepted: 5 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Aim This study investigated the effect of a double-lumen irrigation-suction tube in reducing the incidence of grade C anastomotic leakage (AL) resulting from a selective sigmoid colon cancer radical resection. Method This multicenter retrospective cohort study reviewed data of patients receiving sigmoid colon cancer radical resection from January 2010 to November 2019. The enrolled patients were divided into the passive drainage tube group and the doublelumen irrigation-suction tube group, based on the use of a double-lumen irrigation-suction tube or a passive drainage tube during the surgery. The effect of double-lumen irrigation-suction tube on the incidence of grade C anastomotic leakage was evaluated. Results Of the 761 patients included in the study, 56 patients (7.36%) experienced AL. Of the 56 patients, 22 were diagnosed with grade C AL. The double-lumen irrigation-suction tube was a protective factor for forming a grade C AL compared with the passive drainage tube (OR = 0.194, 95% CI: 0.055–0.686, p = 0.011). Of the 34 patients with grade A or B AL, 26 patients had spontaneous closure—19 in the double-lumen irrigation-suction tube group and 7 in the passive drainage tube group. The doublelumen irrigation-suction tube (multivariable HR = 3.418, 95% CI: 1.43–11.203, p = 0.038) was associated with spontaneous closure of grade A or B AL. Conclusion Placing a double-lumen irrigation-suction tube may reduce the risk of grade C AL resulting from a selective sigmoid colon cancer radical resection. However, this study had substantial selection bias and the results should be reconfirmed by a randomized clinical trial. Keywords Anastomotic leakage . Incidence . Sigmoid colon cancer . Drainage
Introduction Anastomotic leakage (AL) is one of the most difficult postoperative complications resulting from a sigmoid colon cancer * Zheng Yao [email protected] * Risheng Zhao [email protected] 1
Department of General Surgery, Jinling Hospital, Nanjing, Jiangsu, China
2
Department of General Surgery, Zhengzhou Central Hospital, Zhengzhou, Henan, China
3
Department of General Surgery, Nanjing Jiangning Hospital, Hushan Road NO.169, Nanjing, Jiangsu, China
4
Department of General Surgery, Huaihe Hospital, Kaifeng, Henan, China
radical resection [1]. The incidence of AL after a sigmoid colon cancer radical resection varies from 5.1 to 13% [2–5]. Rahbari et al. [6] proposed a definition that comprises a three-grade scale based on the following clinical consequences of AL: no therapeutic intervention required (grade A), active therapeutic intervention without a laparotomy (grade B), and laparotomy (grade
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