[Symptomatic stenoses following stapler anastomosis of the large intestine]

Since 1978 the stapled colonic anastomosis belongs to the technical standard in surgery of the rectosigmoid. It is followed by an extension of indications for sphincter-preserving excisional treatment. The main advantages of the mechanical suturing are the shortening of operation time as well as the practical and easy management, especially when the anastomosis is located low in the pelvis. Early respectively late postoperative strictures represent the most frequent complications of stapled anastomosis. From 1989 to 1991, the stapling technique was used for colorectal anastomosis in 196 cases in our hospital. Clinical stenosis occurred in 5 cases, an incidence of 2.5%. Causative the size of the cartridge, the healing by second intention because of the metallic staples, a disturbed microcirculation depending on the tension around the anastomosis, missing normal fecal dilation because of protective colostomy and an incongruity of the combined lumina are discussed. Independent of localisation and grade of the stricture, repeated dilation was a successful therapy in all 5 cases.