RESUMEN
PURPOSE: This study aimed to investigate the effect of placement of double-lumen irrigation-suction tubes (DLIST) on the closure of anastomotic defect (AD) after rectal cancer surgery. METHODS: The study was carried out at two centers managed by one surgeon, both adopted the same treatments. Patients with postoperative AD after rectal cancer surgery from January 2011 to June 2020 were eligible and were divided into a passive drainage (PD) group and a DLIST group according to whether the PD, placed in the rectal cancer surgery, had been replaced with the DLIST. The effect of DLIST on the AL was evaluated. RESULT: There distributed 76 patients in the DLIST group and 52 in the PD group. A higher closure rate was reported in the DLIST group (46 patients in DLIST group, for a closure rate of 60.5%, and 21 patients in PD group, for a closure rate of 40.4%. HR = 3.05; 95% CI: 1.79-5.19; P < 0.001). Both length of stay and costs of the treatment in the DLIST group were lower (54 days [interquartile range, IQR: 41-17] days vs. 112 days [IQR: 66-27] days, P = 0.005; and $18,721 [IQR: $14,982-4,960] vs. $40,840 [IQR: $20,932-50,529], P < 0.001). CONCLUSION: Placement of DLIST might serve as an effective method for treating AD following rectal cancer surgery. In comparison with PD, it costs lower to apply DLIST in the treatment of AD and the length of stay is shorter.
Asunto(s)
Neoplasias del Recto , Recto , Humanos , Succión , Recto/cirugía , Anastomosis Quirúrgica/métodos , Neoplasias del Recto/cirugía , Neoplasias del Recto/etiología , Drenaje/métodos , Fuga Anastomótica/etiología , Fuga Anastomótica/cirugía , Estudios RetrospectivosRESUMEN
BACKGROUND: This study aimed to investigate the effect of double-lumen irrigation-suction tube (DLIST) in the management of surgical site infections (SSIs) after enterocutaneous fistula (ECF) excisions. METHOD: From January 2016 to December 2017 medical records of patients with ECF excisions were reviewed. Patients with primary superficial SSI were divided into group a (treated with DLIST) and b (treated with delayed primary closures). Patients with primary deep SSI were divided into group A (treated with DLIST) and B (treated with vacuum-assisted closure [VAC]). The effect of the DLIST was evaluated. RESULTS: There were 32 in group a and 27 in group b. The therapeutic time and cost in group a were lower (13.13 ± 2.37 d vs. 24.89 ± 7.44 d; p < .001; $1456 ± 302 vs.$2784 ± 583; p < .001). There were 21 in group A and 23 in group B. While the therapeutic time of group A was longer, the cost was lower ($1717 ± 404 vs. $2636 ± 592; p < .001). CONCLUSIONS: Placing DLIST is an effective and cheap method to treat superficial SSI after ECF excisions. The cost of DLIST in treatment of deep SSI is lower, while the effect of VAC is better.