To assess the clinical value of catheter drainage via an ultrasound-guided parasacral approach for anastomotic leakage following drainage tube removal after rectal cancer surgery.

The clinical data of 23 patients with anastomotic leakage following drainage tube removal after rectal cancer surgery at Zhejiang Cancer Hospital from January 2015 to December 2019 were collected. The cases of anastomotic leakage treated through catheter drainage via an ultrasound-guided parasacral approach were chosen to observe the feasibility of this approach, success rate of catheterization, complications, as well as curative effects.

A total of 23 cases of anastomotic leakage occurred in 23 patients 6~10 days after surgery, with an median occurrence time of 7 days. Computed tomography (CT) in 21 (91.3%, 21/23) patients showed encapsulated effusion around the presacral anastomosis, catheterization route, and successful catheterization; there were no complications related to catheterization; catheters were removed 5~12 days after catheterization, with a median time of 7 days; there was no recurrence of anastomotic fistula in all patients. CT in two (8.7%, 2/23) patients showed that there was scattered effusion around the anastomosis, and ultrasound imaging showed that there were no flaky fluid areas, so surgery was chosen as the treatment solution.

For anastomotic leakage following drainage tube removal after rectal cancer surgery, catheter drainage via an ultrasound-guided parasacral approach should be chosen when CT showed encapsulated effusion around the presacral nastomosis. This approach has excellent safety and effectiveness without requiring secondary surgery.