EP935 - Extra-Peritoneal Tunneling Method Reducing Intraperitoneal Drain Displacement in Rectal Cancer Surgeries: A Large Scale Comparative Study

Tuesday, May 13, 2025

8:21 AM – 8:26 AM PT

ePoster Presenter(s)

Mi Jeong Choi

Fellow
Seoul national university Bundang hospital
Seongnam-si, Kyonggi-do, Republic of Korea

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Author(s)

Min-Hyeong Jo, MD

Fellow
Seoule national university Bundang hospital
seongnamsi, Kyonggi-do, Republic of Korea

Disclosure information not submitted.
Kyongmin Kang, General surgeon

Seoul National University Bundang Hospital
Department of Surgery
Seoul, Seoul-t'ukpyolsi, Republic of Korea

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
HA

Hong-Min Ahn, M.D.

Professor
Seoul National University Bundang Hospital
Seoul, Seoul-t'ukpyolsi, Republic of Korea

Disclosure information not submitted.
HO

Heung-Kwon Oh, n/a

Clinical Professor
SNUBH
Seoul, Seoul-t'ukpyolsi, Republic of Korea

Disclosure information not submitted.
DK

Duck-Woo Kim, n/a

Professor
Seoul National University Bundang Hospital
Seoul, Kyonggi-do, Republic of Korea

Disclosure information not submitted.

Senior Author(s)

SK

Sung-Bum Kang, n/a

Professor
Seoul National University Bundang Hospital
Seoul, Kyonggi-do, Republic of Korea

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.

Mi Jeong Choi: This individual has no financial relationships with ineligible companies.

Kyongmin Kang, General surgeon: This individual has no financial relationships with ineligible companies.

Sung-Bum Kang, n/a: This individual has no financial relationships with ineligible companies.

Image or Table (Do Not add text here):

Purpose/Background: Anastomotic leakage is a serious complication in rectal cancer surgeries, significantly affecting patient outcomes and recovery. Properly positioned drains can facilitate the early detection and management of anastomotic leakage. This study aimed to evaluate the efficacy of the extra-peritoneal tunneling (EPT) method for intra-abdominal drain insertion in reducing drain displacement and its role in managing leakage.

Methods/Interventions: This retrospective study included adult patients with rectal cancer located below 15 cm from the anal verge (AV), who underwent surgery at Seoul National University Bundang Hospital between August 2021 and July 2024. We evaluated baseline characteristics, drain displacement rate, and risk factors for anastomotic leakage. Statistical analyses included chi-squared tests for categorical variables and logistic regression for multivariate analysis to determine the odds ratios of various risk factors.

Results/Outcomes: A total of 228 patients were enrolled, with 111 in the EPT group and 117 in the non-EPT group. Baseline characteristics were comparable between the two groups. There was no significant difference in complication rates (EPT: 22.5% vs. non-EPT: 16.2%, P = 0.24) or operative time (EPT: 233.0 minutes vs. non-EPT: 238.2 minutes, P = 0.66) between the EPT group and the non-EPT group. Leakage rates were also similar between the groups (EPT: 1.8% (2/111) vs. non-EPT: 3.4% (4/117), P = 0.49). However, the EPT method significantly reduced drain displacement (EPT: 4.5% vs. non-EPT: 47.0%, P < 0.01). Multivariate analysis identified the EPT method as a protective factor against drain displacement (odds ratio: 0.02, P < 0.01). Among patients with leakage, drain displacement was significantly more frequent (4 out of 6 patients with leakage had drain displacement, P = 0.04). Two patients with leakage but without drain displacement did not require reoperation or additional interventions.

Conclusion/Discussion: The EPT method reduces the risk of drain displacement in rectal cancer surgeries. The study suggests that a properly positioned drain using EPT technique not only aids in the early detection of leakage but also has therapeutic potential to prevent the need for operative intervention.