Efectividad del tubo endoanal en la prevención de fuga anastomótica en pacientes llevados a cirugía laparoscópica por cáncer de recto

Abstract

Introduction: Anastomotic leakage is a devastating complication after low anterior rectal resection for cancer being the endoanal tube an useful tool in the prevention of this complication. Objective: Evaluate the role of endoanal tube in prevention and/or reduction of anastomotic leakage. Methodology: We conducted a retrospective analysis based on Electronic Medical records obtained from patients with rectal cancer, which were subject to surgical management at the Méderi Hospital network between 2013 and 2017. We collected sociodemographic information and variables of interest from such patients. Afterwards the statistical analysis consisted of logistical regressions to adjust for confusion variables, and evaluate relationship with other independent variables. Results: Our cohort consisted of 152 patients, mostly men (52. 6%). Being the average age was 62 (±12. 8) years. The incidence of stenosis of the anastomosis was found to be 10, 6%, and the overall incidence of anastomotic leak was 13. 8% (8. 1% in the endoanal tube group and 17. 8% in the unexposed group), also finding significant association with postoperative ileus RR: 4. 25 (IC 95%1. 90-9. 52 p: 0. 000), Surgical site infections: Superficial RR: 3. 34 (95% CI1. 38-8. 05 p: 0. 033), deep RR: 12. 17 (95% CI 6. 16-24. 04 p: 0. 000), organ-spatial RR: 15. 88 (95% CI 7. 47-33. 76 p: 0. 000). No significant associations were found between the endoanal tube and the anastomotic leak. Conclusions: The endoanal tube is a low cost device, with no reported morbidity, which can reduce the incidence of anastomotic leakage in patients undergoing surgical management of rectal cancer. Further investigation in this topic is required and the target accrual must be met in order to effectively assess the utility of this device in preventing complications.