Local recurrence after anterior resection for rectal cancer using a double stapling technique.

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Gastrointestinal Oncology

Background:

• Anterior resection is a common surgical procedure for rectal cancer.
• The double stapling technique is frequently used for anastomosis in anterior resections.
• Concerns exist regarding the potential impact of the double stapling technique on local recurrence rates in rectal cancer.

Purpose of the Study:

• To evaluate the safety and efficacy of the double stapling technique in anterior resection for rectal cancer.
• To assess the clinical leak rate and postoperative mortality associated with this technique.
• To investigate the incidence of local and systemic cancer recurrence following double stapling technique resection.

Main Methods:

• A retrospective analysis of 55 patients with rectal cancer (Dukes' A:B:C) who underwent anterior resection.
• The double stapling technique was employed for anastomosis, with a mean distance of 7.2 cm from the anal margin.
• Prospective follow-up was conducted to monitor for cancer recurrence and survival outcomes.

Main Results:

• The clinical leak rate was 9% (five patients).
• Three postoperative deaths occurred due to pulmonary embolism, lower limb ischemia, and renal failure.
• Of the 35 patients with no evidence of cancer at follow-up (median 32 months), pelvic recurrence (four patients) was only observed with widespread metastasis.

Conclusions:

• The double stapling technique in anterior resection for rectal cancer is associated with a manageable leak rate.
• The study did not substantiate theoretical risks of increased local recurrence rates with this technique.
• The findings support the safety and efficacy of the double stapling technique for rectal cancer surgery.