Use of transanal drainage tube to prevent anastomotic leakage: intangible differences between the East and the West

Trans-anal drainage tube is used to reduce the rectal pressure, especially at the anastomotic site and thus to protect the anastomosis. Ideally it serves as and even may replace a diverting stoma. When compared to no treatment, the effectiveness of TDT seems confirmed based on the literature, but it remains uncertain whether TDT can replace the diverting stoma. Despite the insignificant tangible costs of TDT, it seems different cultures put varied weight on the intangible costs such as discomfort and pain to patients after surgery.