Overview
Transanal drainage tube (TDT) has the benefit of reducing intraluminal pressure after rectal surgery and may provide ideal regional environment for anastomotic healing. Postoperative C-reactive protein (CRP) trajectory has a high negative predictive value of 0.99 for ruling out anastomotic leak (AL). Previously, TDT was removed at the surgeon's own discretion. In the present study, we design a single arm study to investigate the safety and efficacy of CRP-guided TDT removal for AL prevention following laparoscopic anterior resection for rectal carcinoma
Eligibility
Inclusion Criteria:
- age from 18 to 75 years old
- male and female
- primary rectal adenocarcinoma
- ASA I, II, or III
- laparoscopic LAR + DST
- with or without preoperative radio- or chemotherapy
- no distal metastasis
- no preoperative bowel obstruction
- no preventive ileostomy or colostomy
- patients and their families can understand and are willing to participate in this study and provide written informed consent
Exclusion Criteria:
- emergency operation
- preoperative abnormal liver function
- tatme or ISR procedure (healing process might differ from anterior resection)
- severe postoperative (Clavien-Dindo grade III IV V) complications other than anastomotic leak
- severe perioperative infection unrelated to anastomotic leak
- patients with serious mental illness
- pregnant or breastfeeding women
- patients with other clinical and laboratory conditions considered by the investigator should not participate in the trial