Transrectal Drainage Tube Use for Preventing Postendoscopic Submucosal Dissection Coagulation Syndrome in Patients...

Area of Science:

• Gastroenterology
• Surgical Oncology
• Clinical Trials

Background:

• Postendoscopic submucosal dissection (ESD) coagulation syndrome (PECS) is a frequent complication following colorectal ESD procedures.
• The increasing incidence of PECS necessitates effective prevention strategies.
• This study aimed to assess the efficacy of transrectal drainage tubes (TDTs) in preventing PECS.

Purpose of the Study:

• To evaluate the effectiveness of transrectal drainage tubes (TDTs) in preventing postendoscopic submucosal dissection (ESD) coagulation syndrome (PECS).
• To compare PECS incidence in patients undergoing colorectal ESD with and without TDT placement.

Main Methods:

• A multicenter, randomized controlled trial involving 224 patients undergoing colorectal ESD for lesions ≥20 mm.
• Patients were allocated 1:1 to receive either a transrectal drainage tube (TDT) or no TDT post-procedure.
• TDTs were inserted 10-15 cm above the anus and removed within 1-3 days.

Main Results:

• The TDT group showed a significantly lower incidence of PECS compared to the non-TDT group (6.25% vs. 17.86%, P = 0.008).
• Subgroup analyses indicated TDTs were particularly effective in preventing PECS in females, patients with tumors <4 cm, left-sided colorectal tumors, and shorter procedure times.
• No significant TDT-related complications were observed, with only one tube dislodging prematurely.

Conclusions:

• Transrectal drainage tubes (TDTs) are an effective method for reducing the incidence of postendoscopic submucosal dissection (ESD) coagulation syndrome (PECS) in patients undergoing colorectal ESD.
• TDTs represent a safe and beneficial intervention for preventing this common postoperative complication.