{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T20:54:37Z","timestamp":1789419277832,"version":"build-2803163510"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T00:00:00Z","timestamp":1748476800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T00:00:00Z","timestamp":1748476800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003392","name":"Natural Science Foundation of Fujian Province","doi-asserted-by":"crossref","award":["2023J011819"],"award-info":[{"award-number":["2023J011819"]}],"id":[{"id":"10.13039\/501100003392","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>To assess whether transanal drainage tubes (TDT) protect against anastomotic leakage (AL) in patients without diverting stomas (DS) after laparoscopic anterior rectal resection (LAR). In the TDT group, after anastomosis of the sigmoid colon to the rectum, a 32F silicone tube was inserted through the anus with the tip of the tube exceeding the anastomosis by more than 5\u00a0cm. The tube was secured around the anus with a skin suture and a drainage bag was attached. It was left in place for 3\u20135\u00a0days postoperatively in the TDT group. In the No-TDT group, no transanal silicone tube drainage was used after the anastomosis. A total of 927 patients (620 in the no-TDT group and 307 in the TDT group) were included in the analysis, and a total of 50 (5.4%) patients were observed to develop AL. After using propensity score matching (PSM) to reduce baseline feature imbalances between the two groups, there were 287 patients in both groups, and the mean retention time of TDT was (4.7\u2009\u00b1\u20091.2) d. The incidence of AL in the TDT group was significantly lower than that in the no-TDT group (3.8% vs. 8.0%, with a the incidence of AL in the TDT group was significantly lower than that in the non-TDT group (3.8% vs. 8.0%, <jats:italic>P<\/jats:italic>\u2009=\u20090.034), but the incidence of AL classification was similar (<jats:italic>P<\/jats:italic>\u2009=\u20090.709). There were no significant differences between the two groups in terms of postoperative complications and postoperative recovery. Multivariate logistic regression analysis revealed that TDT was found to be an independent protective factor for postoperative AL (OR 0.437, 95% CI 0.207\u20130.923, <jats:italic>P<\/jats:italic>\u2009=\u20090.030). The elective use of TDT is a simple and effective protective measure for the prevention of AL in patients without stoma after LAR surgery, helping to reduce the probability of AL. This may be a potential alternative DS method for the appropriate population.<\/jats:p>","DOI":"10.1038\/s41598-025-03440-7","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T08:13:38Z","timestamp":1748506418000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Efficacy of transanal drainage tubes in postoperative anastomotic leakage in patients with laparoscopic anterior rectal resection without diverting stoma"],"prefix":"10.1038","volume":"15","author":[{"given":"Guancong","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiwen","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yincong","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,29]]},"reference":[{"issue":"13","key":"3440_CR1","doi-asserted-by":"publisher","first-page":"1346","DOI":"10.1001\/jama.2015.10529","volume":"314","author":"J Fleshman","year":"2015","unstructured":"Fleshman, J. et al. Effect of laparoscopic-assisted resection vs open resection of stage ii or iii rectal cancer on pathologic outcomes: The ACOSOG Z6051 randomized clinical trial. JAMA 314(13), 1346\u20131355. https:\/\/doi.org\/10.1001\/jama.2015.10529 (2015).","journal-title":"JAMA"},{"issue":"3","key":"3440_CR2","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1016\/s1470-2045(13)70016-0","volume":"14","author":"MHGM van der Pas","year":"2013","unstructured":"van der Pas, M. H. G. M. et al. Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised, phase 3 trial. COLOR II. Lancet Oncol. 14(3), 210\u2013218. https:\/\/doi.org\/10.1016\/s1470-2045(13)70016-0 (2013).","journal-title":"Lancet Oncol."},{"issue":"10","key":"3440_CR3","doi-asserted-by":"publisher","first-page":"2197","DOI":"10.1007\/s00464-008-0260-y","volume":"23","author":"H Kuroyanagi","year":"2009","unstructured":"Kuroyanagi, H. et al. Laparoscopic-assisted anterior resection with double-stapling technique anastomosis: safe and feasible for lower rectal cancer?. Surg. Endosc. 23(10), 2197\u20132202. https:\/\/doi.org\/10.1007\/s00464-008-0260-y (2009).","journal-title":"Surg. Endosc."},{"issue":"6","key":"3440_CR4","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1007\/s00384-021-03851-8","volume":"36","author":"KT Choy","year":"2021","unstructured":"Choy, K. T., Yang, T. W. W., Heriot, A., Warrier, S. K. & Kong, J. C. Does rectal tube\/transanal stent placement after an anterior resection for rectal cancer reduce anastomotic leak? A systematic review and meta-analysis. Int. J. Colorectal Dis. 36(6), 1123\u20131132. https:\/\/doi.org\/10.1007\/s00384-021-03851-8 (2021).","journal-title":"Int. J. Colorectal Dis."},{"issue":"6","key":"3440_CR5","doi-asserted-by":"publisher","first-page":"1597","DOI":"10.1016\/j.surg.2016.12.011","volume":"161","author":"T Watanabe","year":"2017","unstructured":"Watanabe, T. et al. Prediction model for complications after low anterior resection based on data from 33,411 Japanese patients included in the National Clinical Database. Surgery 161(6), 1597\u20131608. https:\/\/doi.org\/10.1016\/j.surg.2016.12.011 (2017).","journal-title":"Surgery"},{"issue":"7","key":"3440_CR6","first-page":"528","volume":"122","author":"P Klein","year":"1997","unstructured":"Klein, P., Immler, F., Sterk, P. & Schubert, F. Secure anastomoses of the large intestine (especially with transanal drainage. Zentralbl. Chir. 122(7), 528\u2013532 (1997).","journal-title":"Zentralbl. Chir."},{"issue":"12","key":"3440_CR7","doi-asserted-by":"publisher","first-page":"1151","DOI":"10.1001\/jamasurg.2021.4568","volume":"156","author":"S Zhao","year":"2021","unstructured":"Zhao, S. et al. Transanal drainage tube use for preventing anastomotic leakage after laparoscopic low anterior resection in patients with rectal cancer: A randomized clinical trial. JAMA Surg. 156(12), 1151\u20131158. https:\/\/doi.org\/10.1001\/jamasurg.2021.4568 (2021).","journal-title":"JAMA Surg."},{"issue":"3","key":"3440_CR8","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1016\/j.amjsurg.2020.12.054","volume":"222","author":"K Tamura","year":"2021","unstructured":"Tamura, K. et al. Laparoscopic anterior resection with or without transanal tube for rectal cancer patients\u2014A multicenter randomized controlled trial. Am. J. Surg. 222(3), 606\u2013612. https:\/\/doi.org\/10.1016\/j.amjsurg.2020.12.054 (2021).","journal-title":"Am. J. Surg."},{"issue":"2","key":"3440_CR9","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1007\/s00464-015-4237-3","volume":"30","author":"K Shigeta","year":"2016","unstructured":"Shigeta, K. et al. A meta-analysis of the use of a transanal drainage tube to prevent anastomotic leakage after anterior resection by double-stapling technique for rectal cancer. Surg. Endosc. 30(2), 543\u2013550. https:\/\/doi.org\/10.1007\/s00464-015-4237-3 (2016).","journal-title":"Surg. Endosc."},{"issue":"3","key":"3440_CR10","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1016\/j.suronc.2018.05.018","volume":"27","author":"H Chen","year":"2018","unstructured":"Chen, H., Cai, H. K. & Tang, Y. H. An updated meta-analysis of transanal drainage tube for prevention of anastomotic leak in anterior resection for rectal cancer. Surg. Oncol. 27(3), 333\u2013340. https:\/\/doi.org\/10.1016\/j.suronc.2018.05.018 (2018).","journal-title":"Surg. Oncol."},{"issue":"6","key":"3440_CR11","doi-asserted-by":"publisher","first-page":"313","DOI":"10.4174\/astr.2015.89.6.313","volume":"89","author":"GW Ha","year":"2015","unstructured":"Ha, G. W., Kim, H. J. & Lee, M. R. Transanal tube placement for prevention of anastomotic leakage following low anterior resection for rectal cancer: A systematic review and meta-analysis. Ann. Surg. Treat Res. 89(6), 313\u2013318. https:\/\/doi.org\/10.4174\/astr.2015.89.6.313 (2015).","journal-title":"Ann. Surg. Treat Res."},{"issue":"4","key":"3440_CR12","doi-asserted-by":"publisher","first-page":"1513","DOI":"10.1007\/s00464-016-5193-2","volume":"31","author":"Y Yang","year":"2017","unstructured":"Yang, Y. et al. Prophylactic transanal decompression tube versus non-prophylactic transanal decompression tube for anastomotic leakage prevention in low anterior resection for rectal cancer: A meta-analysis. Surg. Endosc. 31(4), 1513\u20131523. https:\/\/doi.org\/10.1007\/s00464-016-5193-2 (2017).","journal-title":"Surg. Endosc."},{"issue":"6","key":"3440_CR13","doi-asserted-by":"publisher","first-page":"1202","DOI":"10.4240\/wjgs.v15.i6.1202","volume":"15","author":"S Fujino","year":"2023","unstructured":"Fujino, S., Yasui, M., Ohue, M. & Miyoshi, N. Efficacy of transanal drainage tube in preventing anastomotic leakage after surgery for rectal cancer: A meta-analysis. World J. Gastrointest. Surg. 15(6), 1202\u20131210. https:\/\/doi.org\/10.4240\/wjgs.v15.i6.1202 (2023).","journal-title":"World J. Gastrointest. Surg."},{"issue":"4","key":"3440_CR14","doi-asserted-by":"publisher","first-page":"e164","DOI":"10.1016\/j.surge.2022.11.002","volume":"21","author":"YX Zhang","year":"2023","unstructured":"Zhang, Y. X., Jin, T. & Yang, K. The role of transanal drainage tube in preventing the anastomotic leakage in rectal cancer surgery without a defunctioning stoma: A meta-analysis. Surgeon 21(4), e164\u2013e172. https:\/\/doi.org\/10.1016\/j.surge.2022.11.002 (2023).","journal-title":"Surgeon"},{"key":"3440_CR15","doi-asserted-by":"publisher","first-page":"1198549","DOI":"10.3389\/fonc.2023.1198549","volume":"13","author":"S Xia","year":"2023","unstructured":"Xia, S. et al. Transanal drainage tube for the prevention of anastomotic leakage after rectal cancer surgery: A meta-analysis of randomized controlled trials. Meta Front. Oncol. 13, 1198549. https:\/\/doi.org\/10.3389\/fonc.2023.1198549 (2023).","journal-title":"Meta Front. Oncol."},{"issue":"4","key":"3440_CR16","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1080\/14737140.2023.2179991","volume":"23","author":"W Wang","year":"2023","unstructured":"Wang, W., Zhang, J., Cai, J., Zhao, X. & Wang, F. Transanal drainage tube for the prevention of anastomotic leakage in anterior resection for rectal cancer: A systematic review and meta-analysis. Expert Rev. Anticancer Ther. 23(4), 431\u2013442. https:\/\/doi.org\/10.1080\/14737140.2023.2179991 (2023).","journal-title":"Expert Rev. Anticancer Ther."},{"issue":"6","key":"3440_CR17","doi-asserted-by":"publisher","first-page":"1367","DOI":"10.1007\/s00268-011-1053-3","volume":"35","author":"L Xiao","year":"2011","unstructured":"Xiao, L. et al. Can transanal tube placement after anterior resection for rectal carcinoma reduce anastomotic leakage rate? A single-institution prospective randomized study. World J. Surg. 35(6), 1367\u20131377. https:\/\/doi.org\/10.1007\/s00268-011-1053-3 (2011).","journal-title":"World J. Surg."},{"key":"3440_CR18","doi-asserted-by":"publisher","first-page":"6","DOI":"10.21037\/tgh.2019.10.16","volume":"5","author":"F Carboni","year":"2020","unstructured":"Carboni, F. et al. Transanal drainage tube: Alternative option to defunctioning stoma in rectal cancer surgery?. Transl. Gastroenterol. Hepatol. 5, 6. https:\/\/doi.org\/10.21037\/tgh.2019.10.16 (2020).","journal-title":"Transl. Gastroenterol. Hepatol."},{"issue":"6","key":"3440_CR19","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1111\/j.1463-1318.2006.00994.x","volume":"8","author":"S Bulow","year":"2006","unstructured":"Bulow, S., Bulut, O., Christensen, I. J., Harling, H., Rectal Stent Study G. Transanal stent in anterior resection does not prevent anastomotic leakage. Colorectal Dis. 8(6), 494\u2013496. https:\/\/doi.org\/10.1111\/j.1463-1318.2006.00994.x (2006).","journal-title":"Colorectal Dis."},{"issue":"1","key":"3440_CR20","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1186\/s12885-024-11990-8","volume":"24","author":"Y Liu","year":"2024","unstructured":"Liu, Y. et al. Does transanal drainage tubes placement have an impact on the incidence of anastomotic leakage after rectal cancer surgery? A systematic review and meta-analysis. BMC Cancer 24(1), 263. https:\/\/doi.org\/10.1186\/s12885-024-11990-8 (2024).","journal-title":"BMC Cancer"},{"issue":"11","key":"3440_CR21","doi-asserted-by":"publisher","first-page":"1273","DOI":"10.1111\/codi.16231","volume":"24","author":"C Guo","year":"2022","unstructured":"Guo, C., Fu, Z., Qing, X. & Deng, M. Prophylactic transanal drainage tube placement for preventing anastomotic leakage after anterior resection for rectal cancer: A meta-analysis. Colorectal. Dis. 24(11), 1273\u20131284. https:\/\/doi.org\/10.1111\/codi.16231 (2022).","journal-title":"Colorectal. Dis."},{"issue":"3","key":"3440_CR22","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1159\/000497168","volume":"35","author":"PK Garg","year":"2019","unstructured":"Garg, P. K., Goel, A., Sharma, S., Chishi, N. & Gaur, M. K. Protective diversion stoma in low anterior resection for rectal cancer: A meta-analysis of randomized controlled trials. Visc. Med. 35(3), 156\u2013160. https:\/\/doi.org\/10.1159\/000497168 (2019).","journal-title":"Visc. Med."},{"issue":"5","key":"3440_CR23","doi-asserted-by":"publisher","first-page":"387","DOI":"10.3322\/caac.21345","volume":"66","author":"LJ Herrinton","year":"2016","unstructured":"Herrinton, L. J. et al. Conversations for providers caring for patients with rectal cancer: Comparison of long-term patient-centered outcomes for patients with low rectal cancer facing ostomy or sphincter-sparing surgery. CA Cancer J. Clin. 66(5), 387\u2013397. https:\/\/doi.org\/10.3322\/caac.21345 (2016).","journal-title":"CA Cancer J. Clin."},{"issue":"9","key":"3440_CR24","doi-asserted-by":"publisher","first-page":"1929","DOI":"10.1007\/s00384-021-03967-x","volume":"36","author":"JH Lee","year":"2021","unstructured":"Lee, J. H., Ahn, B. K., Ryu, J. & Lee, K. H. Mechanical bowel preparation combined with oral antibiotics in colorectal cancer surgery: A nationwide population-based study. Int. J. Colorectal. Dis. 36(9), 1929\u20131935. https:\/\/doi.org\/10.1007\/s00384-021-03967-x (2021).","journal-title":"Int. J. Colorectal. Dis."},{"issue":"10","key":"3440_CR25","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1002\/bjs.1800691019","volume":"69","author":"RJ Heald","year":"1982","unstructured":"Heald, R. J., Husband, E. M. & Ryall, R. D. The mesorectum in rectal cancer surgery\u2013the clue to pelvic recurrence?. Br. J. Surg. 69(10), 613\u2013616. https:\/\/doi.org\/10.1002\/bjs.1800691019 (1982).","journal-title":"Br. J. Surg."},{"issue":"10","key":"3440_CR26","doi-asserted-by":"publisher","first-page":"2988","DOI":"10.1007\/s00464-014-3564-0","volume":"28","author":"K Kawada","year":"2014","unstructured":"Kawada, K. et al. Risk factors for anastomotic leakage after laparoscopic low anterior resection with DST anastomosis. Surg. Endosc. 28(10), 2988\u20132995. https:\/\/doi.org\/10.1007\/s00464-014-3564-0 (2014).","journal-title":"Surg. Endosc."},{"issue":"3","key":"3440_CR27","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1016\/j.surg.2009.10.012","volume":"147","author":"NN Rahbari","year":"2010","unstructured":"Rahbari, N. N. et al. Definition and grading of anastomotic leakage following anterior resection of the rectum: A proposal by the International Study Group of Rectal Cancer. 38Surgery 147(3), 339\u2013351. https:\/\/doi.org\/10.1016\/j.surg.2009.10.012 (2010).","journal-title":"38Surgery"},{"issue":"19","key":"3440_CR28","doi-asserted-by":"publisher","first-page":"2265","DOI":"10.1002\/(sici)1097-0258(19981015)17:19<2265::aid-sim918>3.0.co;2-b","volume":"17","author":"RB D'Agostino","year":"1998","unstructured":"D\u2019Agostino, R. B. Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat. med. 17(19), 2265\u20132281. https:\/\/doi.org\/10.1002\/(sici)1097-0258(19981015)17:19%3c2265::aid-sim918%3e3.0.co;2-b (1998).","journal-title":"Stat. med."},{"issue":"10","key":"3440_CR29","doi-asserted-by":"publisher","first-page":"4323","DOI":"10.1016\/j.asjsur.2023.06.123","volume":"46","author":"T Mukai","year":"2023","unstructured":"Mukai, T., Maki, A., Shimizu, H. & Kim, H. The economic burdens of anastomotic leakage for patients undergoing colorectal surgery in Japan. Asian J. Surg. 46(10), 4323\u20134329. https:\/\/doi.org\/10.1016\/j.asjsur.2023.06.123 (2023).","journal-title":"Asian J. Surg."},{"issue":"2","key":"3440_CR30","doi-asserted-by":"publisher","first-page":"100","DOI":"10.4174\/astr.2021.100.2.100","volume":"100","author":"SH Cho","year":"2021","unstructured":"Cho, S. H. et al. The usefulness of transanal tube for reducing anastomotic leak in mid rectal cancer: Compared to diverting stoma. Ann. Surg. Treat Res. 100(2), 100\u2013108. https:\/\/doi.org\/10.4174\/astr.2021.100.2.100 (2021).","journal-title":"Ann. Surg. Treat Res."},{"issue":"1","key":"3440_CR31","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1186\/s12893-020-00811-x","volume":"20","author":"Y Luo","year":"2020","unstructured":"Luo, Y., Zhu, C. K., Wu, D. Q., Zhou, L. B. & Wang, C. S. Effect comparison of three different types of transanal drainage tubes after anterior resection for rectal cancer. BMC Surg. 20(1), 166. https:\/\/doi.org\/10.1186\/s12893-020-00811-x (2020).","journal-title":"BMC Surg."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-03440-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-03440-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-03440-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T08:13:39Z","timestamp":1748506419000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-03440-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,29]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["3440"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-03440-7","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,29]]},"assertion":[{"value":"10 November 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"This study was reviewed and approved by the Medical Ethics Committee of Zhangzhou Affiliated Hospital of Fujian Medical University (Grant No. 2024LWB363). All methods were performed in accordance with relevant guidelines and regulations (Declaration of Helsinki). Informed consent was obtained from all subjects and\/or their legal guardians (s) for this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}],"article-number":"18834"}}