Anastomotic leak after anterior resection is associated with increased morbidity and mortality. Although few studies have shown that transanastomotic tube placement after anterior resection may reduce the risk of anastomotic leak and other complications, this approach has not been commonly practiced. Thus, this study evaluated the efficacy of transanastomotic tube placement to prevent complications after anterior resection.

This retrospective study evaluated postoperative complications in 71 patients after anterior resection performed using a circular stapler. From January 2013 to December 2015, patients did not receive a transanastomotic tube, and from January 2016 to December 2020, a transanastomotic tube was placed in all patients. These patients were followed-up until discharge. Several patient and treatment factors were compared between patients who underwent anastomosis with and without tube placement.

Transanastomotic tube was placed in 49/71 patients. The incidence of postoperative complications was significantly lower in patients with transanastomotic tube (p = 0.008 [univariable]; p = 0.013 [multivariable; odds ratio, 0.144 (0.031–0.667)]), and these patients passed stool significantly earlier (p = 0.003). There was no difference in other patient and treatment/surgical factors between patients with and without postoperative complications.

Transanastomotic tube placement is a simple procedure that facilitates the early return of bowel activity and reduces the incidence of complications after anterior resection.