Authors
Xiaobin Zhang, Zhao Chen, Zongyu Liang
Published in
Journal of gastrointestinal oncology. Volume 17. Issue 3. Pages 159. Jun 30, 2026. Epub May 26, 2026.
Abstract
Anastomotic leakage (AL) remains a significant postoperative concern in rectal cancer patients following anterior resection. This study aims to compare the effectiveness of a transanal drainage tube (TDT) versus a diverting stoma (DS) in reducing the incidence of this complication.
The systematic review was conducted following a comprehensive search of the PubMed, EMBASE, Web of Science, and Cochrane Library databases for all relevant studies published from inception to December 2025. For the meta-analyses, Review Manager 5.4 software was used, with a random-effects model applied as needed.
A total of seven studies encompassing 1,347 participants were included in the analysis. Overall, no significant difference in the risk of AL was observed between the TDT and DS groups [odds ratio (OR) =0.73, 95% confidence interval (CI): 0.42 to 1.29, P=0.28]. Specifically, the TDT group exhibited a significantly lower incidence of bowel obstruction (OR =0.16, 95% CI: 0.08 to 0.32, P<0.01). Rates of other complications and postoperative length of stay were comparable between the two groups.
Our findings indicate that no significant difference was observed between TDT and DS in reducing AL after anterior resection for rectal cancer. Notably, TDT use was associated with a significantly lower incidence of postoperative bowel obstruction. For selected patients, TDT may offer a strategy to avoid stoma-related complications and the need for reversal surgery.
PMID:
42434276
Bibliographic data and abstract were imported from PubMed on 11 Jul 2026.
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