Abstract
Anastomotic leakage is a significant complication following colorectal surgery, impacting patient outcomes and quality of life. This study evaluates the outcomes of primary anastomosis with rectal tube placement in rectosigmoid cancer patients. A retrospective cross-sectional study was conducted at Rouhani and Beheshti hospitals, affiliated with Babol University of Medical Sciences, from 2014 to 2024. Of 154 patients, 148 were included after applying inclusion/exclusion criteria. Data on age, gender, anastomotic leakage, postoperative complications, and bowel function (assessed via Wexner Qualitative Function Scale) were extracted from hospital records. Statistical analyses used chi-square and Fisher’s exact tests (p<0.05). The cohort (52.7% male, mean age 58.58 ± 4.42 years) showed a 4.7% anastomotic leakage rate, with no sepsis, reoperation, or mortality. Most patients exhibited normal bowel function (82.4% normal frequency, 92.6% normal consistency). Leakage was significantly associated with frequent defecation (p=0.001), loose/watery stools (p<0.001), fecal leakage (p<0.001), and short urgency (p=0.001), but not age (p=0.672) or gender (p=0.073). Males reported higher short urgency (p=0.005). Rectal tube placement may reduce anastomotic leakage and improve bowel function in rectosigmoid cancer surgery. The low leakage rate and absence of severe complications suggest clinical benefits, though the retrospective design and lack of a control group limit causal inferences. Future prospective studies with control groups are needed to confirm these findings.