Study on transanal tube drainage after endoscopic resection of giant colorectal polyp

doi:10.16139/j.1007-9610.2022.04.015

Abstract

Abstract:

Objective To investigate the clinical effect of transanal tube drainage and anal decompression after endoscopic submucosal dissection (ESD) of giant colorectal polyp for postoperative recovery and the prevention of complication. Methods Prospective clinical randomized control study was done. Enrolled patients with giant colorectal polyps (diameter ≥3 cm) were divided into 100 cases in endoscopic treatment group(endoscopic group) and 92 cases in endoscopic treatment with prophylactic anal tube implantation group (endoscopic anal tube group). Postoperative recovery and complication between 2 groups were compared. Results Delay bleeding from anal of postoperative complications was present 5(5.0%) cases in endoscopic group and 2(2.2%) cases in endoscopic anal tube group. There were electrocoagulation syndrome of complications 7 (7.0%) cases in endoscopic group and 1(1.1%) case in endoscopic anal tube group. The difference in postoperative complication rate was significant statistically(P<0.05). The temperature 3 days after surgery of patients in endoscopic group and endoscopic anal tube group was (37.2±0.8) ℃ and (37.1±0.6) ℃, respectively without significant diffe-rence (P>0.05) between two groups. Intestinal peristalsis returned (22.5±5.9) h after operation in endoscopic anal tube group and (39.3±10.4) h in endoscopic group with statistically significant differences (P<0.01) between two groups. Abdominal pain score was (2.2±1.3) in endoscopic anal tube group, which was lower than that (4.7±2.2) in endoscopic group statistical significantly (P<0.01). On the first day after operation, intestinal cavity of endoscopic group expanded significantly more compared with that of endoscopic anal tube group by abdominal plain radiograph. Conclusions Anal decompression and drainage after ESD of giant colorectal polyp could be simple and safe preventive measures with low rate of postoperative complications and better recover which would be worth use during ESD.

Key words: Giant colorectal polyp, Endoscopic submucosal dissection, Anal decompression, Postoperative delay bleeding, Electrocoagulation syndrome

CLC Number:

HAN Huazhong, XU Chunhua, FAN Wenjie, QI Zhipeng, LI Bing, ZHOU Pinghong, YAO Liqing, ZHONG Yunshi, LU Pinxiang. Study on transanal tube drainage after endoscopic resection of giant colorectal polyp[J]. Journal of Surgery Concepts & Practice, 2022, 27(04): 351-356.

Figures/Tables 9

References 34

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项目	内镜肛管组 (n=92)	内镜治疗组 (n=100)	t值	P值
病变位置
右半结肠	19(20.7)	22(22.0)
左半结肠	23(25.0)	27(27.0)
直肠	50(54.3)	51(51.0)
病变直径(cm)	4.0±0.9	3.9±0.9	-0.05	0.96
术中穿孔	2^a)	0
术后并发症	3	12	17	0.04
迟发性出血	2(2.2)	5(5.0)
电凝综合征	1(1.1)	7(7.0)
术后3 d的体温(℃)	37.1±0.6	37.2±0.8	0.5	0.7
肠蠕动恢复时间(h)	22.5±5.9	39.3±10.4	13.7	<0.01
腹痛程度评分(分)	2.2±1.3	4.7±2.2	9.5	<0.01