Clinical Outcomes of Transanal Drainage Tube Placement Following Surgical Repair for Chronic III-IV Perineal Tears

To evaluate the outcome and safety of transanal drainage tube (TDT) placement following surgical repair of chronic third- and fourth-degree perineal tears.

A retrospective cohort study was conducted at Peking Union Medical College Hospital (2016-2024), including 31 patients with chronic perineal tears who underwent surgical repair. Patients were stratified into success (n=23) and failure (n=8) groups. Surgical failure was defined as persistence of fecal incontinence at six months postoperatively. Data included demographics, surgical details, TDT use, Wexner, and SF-12 scores.

The procedure demonstrated an overall success rate of 74.2% (23/31). Postoperative SF-12 and Wexner scores improved significantly in both the success and failure groups (p < 0.05). The success group had longer tube retention (9[7-11.5] vs 7[6-7] days, p=0.03). Further analysis revealed that prolonged drainage duration beyond 8 days was associated with improved success rates. Patients in the TDT group showed significantly greater improvement in Wexner scores (11.42 ± 3.13 vs 7.67 ± 3.37, p = 0.004). No major TDT-related complications occurred.

Transanal drainage tube placement may enhance anal sphincter function when used at the time of anal sphincteroplasty. Maintaining TDT for more than 8 days is associated with higher success rate. Both successful and unsuccessful repairs lead to significant improvements in quality of life and fecal incontinence symptoms.