The effect of postoperative recovery between trans-abdominal drainage and trans-perineum drainage in patients with rectal cancer: a meta-analysis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

TIAN Hongpeng ^1,2 , CHEN Xiaobo ^1,2 , HOU Songlin ¹ , LIU Daizhi ² , ZHANG Guangjun ^1,2 ,  ZHOU Tong ^1,2

1. Department of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R.China;
2. Institute of Hepato-Biliary-Pancreas and Intestinal Disease, North Sichuan Medical College, Nanchong, Sichuan 637000, P.R.China;

Corresponding?author：

ZHOU Tong, Email: zhoutong0088@163.com

Keywords：

rectal cancer; trans-abdominal drainage; trans-perineum drainage; recovery; meta-analysis

DOI：

10.7507/1007-9424.201611020

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the effect of postoperative recovery between trans-abdominal drainage and trans-perineum drainage in patients with rectal cancer. Methods The randomized controlled trials which were related with the comparison between trans-abdominal drainage and trans-perineum drainage of rectal cancer patients were searched from January 2006 to January 2016, and then a meta-analysis was performed by using RevMan 5.2 software, basing on the data obtained from PubMed, CBM, CNKI, WanFang, and VIP database. Results The results of meta-analysis showed that, in the aspect of postoperative drainage, there was no significant difference in the postoperative drainage duration 〔MD=–0.03, 95% CI is (–1.63, 1.57), P=0.97〕 , volume of drainage liquid 〔MD=–9.53, 95% CI is (–104.95, 85.90), P=0.84〕 , and extubation time 〔MD=0.25, 95% CI is (–0.31, 0.82), P=0.38〕 between the trans-abdominal drainage group and the trans-perineum drainage group. In terms of postoperative infection, the trans-abdominal drainage could effectively reduce the incidence rate of drainage tube incision infection 〔OR=0.32, 95% CI is (0.21, 0.48), P<0.000 01〕 . However, there was no significant difference in the abdominal incision infection 〔OR=0.84, 95% CI is (0.51, 1.36), P=0.48〕 and pelvic infection 〔OR=0.77, 95% CI is (0.52, 1.15), P=0.20〕 . In addition, compared to the trans-perineum drainage, the trans-abdominal drainage could shorten the time of pain in drainage 〔MD=–5.07, 95% CI is (–6.96, –3.17), P<0.000 01〕 . But, there was no significant difference in the duration of hospitalization 〔MD=0.82, 95% CI is (–0.39, 2.03), P=0.19〕 , incidence of anastomotic bleeding 〔OR=0.95, 95% CI is (0.58, 1.54), P=0.82〕 , and incidence of anastomotic leakage 〔OR=1.33, 95% CI is (0.93, 1.92), P=0.12〕 between the two groups. Conclusion The trans-abdominal drainage could obviously decrease the incidence of drainage tube incision infection and shorten the time of pain in drainage, so it may promote the postoperative rehabilitation of rectal cancer patients.

Citation： TIAN Hongpeng, CHEN Xiaobo, HOU Songlin, LIU Daizhi, ZHANG Guangjun, ZHOU Tong. The effect of postoperative recovery between trans-abdominal drainage and trans-perineum drainage in patients with rectal cancer: a meta-analysis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(6): 691-700. doi: 10.7507/1007-9424.201611020 Copy

1.	Binefa G, Rodríguez-Moranta F, Teule A, et al. Colorectal cancer: from prevention to personalized medicine. World J Gastroenterol, 2014, 20(22): 6786-6808.
2.	Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer, 2010, 127(12): 2893-2917.
3.	Peeters KC, Tollenaar RA, Marijnen CA, et al. Risk factors for anastomotic failure after total mesorectal excision of rectal cancer. Br J Surg, 2005, 92(2): 211-216.
4.	曾憲濤, 包翠萍, 曹世義, 等. Meta 分析系列之三: 隨機對照試驗的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(3): 183-185.
5.	丁惠珍, 張亞琪. 不同引流方式對腹腔鏡直腸癌 Miles 手術患者術后康復的影響. 江蘇醫藥, 2013, 39(6): 731-732.
6.	何建軍, 霍永平, 任予, 等. 經會陰引流在防治直腸癌 Dixon 術后吻合口瘺中的作用. 現代腫瘤醫學, 2006, 14(12): 1579-1580.
7.	陳世君, 錢昆, 王勇強. 直腸癌 Dixon 術后不同引流方式對患者預后影響的對比分析. 現代預防醫學, 2009, 36(21): 4194-4195, 4200.
8.	汪飚, 張貽超, 趙一超. 直腸癌切除后經肛周盆底引流的應用. 中國現代醫生, 2008, 46(27): 86-87.
9.	馬利安. 直腸癌術后 2 種引流方式的臨床效果分析. 河北醫科大學學報, 2010, 31(6): 651-653.
10.	王亞儒. 經后會陰骶前引流預防和治療中低位直腸癌吻合口瘺. 中國現代普通外科進展, 2012, 15(6): 495-496.
11.	趙紫罡, 伍曉汀, 錢昆. 低位直腸癌 Dixon 術引流方式評價. 四川大學學報(醫學版), 2012, 43(1): 135-136.
12.	卿昭勇. 低位直腸癌 Dixon 術后兩種骶前引流方式比較分析. 重慶醫學, 2014, 43(29): 3958-3960.
13.	劉浩乾, 何紀恩, 賀利榮. 中低位直腸癌術后經會陰骶前引流與經腹壁引流的比較分析. 浙江臨床醫學, 2014, 16(10): 1631-1632.
14.	Wang JH, King TM, Chang MC, et al. Drainage placement through the extraperitoneal tunnel can prevent its postoperative dislodgement effectively in laparoscopic rectal surgery. Surg Laparosc Endosc Percutan Tech, 2013, 23(4): 410-414.
15.	Pera M, Pascual M. Quality standards in rectal cancer surgery. Gastroenterol Hepatol, 2005, 28(7): 417-425.
16.	邱輝忠, 林國樂, 吳斌, 等. 直腸癌全直腸系膜切除的若干問題 (附 75 例報告). 中國實用外科雜志, 2003, 23(6): 348-349.
17.	Heald RJ, Moran BJ, Brown G, et al. Optimal total mesorectal excision for rectal cancer is by dissection in front of Denonvilliers’ fascia. Br J Surg, 2004, 91(1): 121-123.
18.	Eckmann C, Kujath P, Schiedeck TH, et al. Anastomotic leakage following low anterior resection: results of a standardized diagnostic and therapeutic approach. Int J Colorectal Dis, 2004, 19(2): 128-133.
19.	沈伯明, 周立新, 俞偉君. 結直腸癌術后吻合口漏的預防與處理. 結直腸肛門外科, 2011, 17(1): 23-25.
20.	Averbach AM, Sugarbaker PH. The use of drains in elective surgery for colorectal cancer: always, never or selectively? Tumori, 1995, 81(3 Suppl): 89-97.
21.	謝尚奎, 吳印愛, 劉獻棠, 等. 直腸癌保肛術中行吻合口上下雙管引流效果的觀察. 中國普外基礎與臨床雜志, 2001, 8(1): 47-48.
22.	馬留學, 李景永, 王瑜, 等. 三管沖洗引流在預防直腸癌 TME 術后吻合口瘺中的應用. 中國普通外科雜志, 2011, 20(10): 1040-1043.
23.	Chen YS, Bo XB, Gu DY, et al. Outcomes of laparoscopic abdominoperineal resection in low rectal cancer using different pelvic drainages. Asian Pac J Cancer Prev, 2015, 16(1): 153-155.

1. Binefa G, Rodríguez-Moranta F, Teule A, et al. Colorectal cancer: from prevention to personalized medicine. World J Gastroenterol, 2014, 20(22): 6786-6808.
2. Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer, 2010, 127(12): 2893-2917.
3. Peeters KC, Tollenaar RA, Marijnen CA, et al. Risk factors for anastomotic failure after total mesorectal excision of rectal cancer. Br J Surg, 2005, 92(2): 211-216.
4. 曾憲濤, 包翠萍, 曹世義, 等. Meta 分析系列之三: 隨機對照試驗的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(3): 183-185.
5. 丁惠珍, 張亞琪. 不同引流方式對腹腔鏡直腸癌 Miles 手術患者術后康復的影響. 江蘇醫藥, 2013, 39(6): 731-732.
6. 何建軍, 霍永平, 任予, 等. 經會陰引流在防治直腸癌 Dixon 術后吻合口瘺中的作用. 現代腫瘤醫學, 2006, 14(12): 1579-1580.
7. 陳世君, 錢昆, 王勇強. 直腸癌 Dixon 術后不同引流方式對患者預后影響的對比分析. 現代預防醫學, 2009, 36(21): 4194-4195, 4200.
8. 汪飚, 張貽超, 趙一超. 直腸癌切除后經肛周盆底引流的應用. 中國現代醫生, 2008, 46(27): 86-87.
9. 馬利安. 直腸癌術后 2 種引流方式的臨床效果分析. 河北醫科大學學報, 2010, 31(6): 651-653.
10. 王亞儒. 經后會陰骶前引流預防和治療中低位直腸癌吻合口瘺. 中國現代普通外科進展, 2012, 15(6): 495-496.
11. 趙紫罡, 伍曉汀, 錢昆. 低位直腸癌 Dixon 術引流方式評價. 四川大學學報(醫學版), 2012, 43(1): 135-136.
12. 卿昭勇. 低位直腸癌 Dixon 術后兩種骶前引流方式比較分析. 重慶醫學, 2014, 43(29): 3958-3960.
13. 劉浩乾, 何紀恩, 賀利榮. 中低位直腸癌術后經會陰骶前引流與經腹壁引流的比較分析. 浙江臨床醫學, 2014, 16(10): 1631-1632.
14. Wang JH, King TM, Chang MC, et al. Drainage placement through the extraperitoneal tunnel can prevent its postoperative dislodgement effectively in laparoscopic rectal surgery. Surg Laparosc Endosc Percutan Tech, 2013, 23(4): 410-414.
15. Pera M, Pascual M. Quality standards in rectal cancer surgery. Gastroenterol Hepatol, 2005, 28(7): 417-425.
16. 邱輝忠, 林國樂, 吳斌, 等. 直腸癌全直腸系膜切除的若干問題 (附 75 例報告). 中國實用外科雜志, 2003, 23(6): 348-349.
17. Heald RJ, Moran BJ, Brown G, et al. Optimal total mesorectal excision for rectal cancer is by dissection in front of Denonvilliers’ fascia. Br J Surg, 2004, 91(1): 121-123.
18. Eckmann C, Kujath P, Schiedeck TH, et al. Anastomotic leakage following low anterior resection: results of a standardized diagnostic and therapeutic approach. Int J Colorectal Dis, 2004, 19(2): 128-133.
19. 沈伯明, 周立新, 俞偉君. 結直腸癌術后吻合口漏的預防與處理. 結直腸肛門外科, 2011, 17(1): 23-25.
20. Averbach AM, Sugarbaker PH. The use of drains in elective surgery for colorectal cancer: always, never or selectively? Tumori, 1995, 81(3 Suppl): 89-97.
21. 謝尚奎, 吳印愛, 劉獻棠, 等. 直腸癌保肛術中行吻合口上下雙管引流效果的觀察. 中國普外基礎與臨床雜志, 2001, 8(1): 47-48.
22. 馬留學, 李景永, 王瑜, 等. 三管沖洗引流在預防直腸癌 TME 術后吻合口瘺中的應用. 中國普通外科雜志, 2011, 20(10): 1040-1043.
23. Chen YS, Bo XB, Gu DY, et al. Outcomes of laparoscopic abdominoperineal resection in low rectal cancer using different pelvic drainages. Asian Pac J Cancer Prev, 2015, 16(1): 153-155.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The effect of postoperative recovery between trans-abdominal drainage and trans-perineum drainage in patients with rectal cancer: a meta-analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content