Single versus double stapling anastomotic technique in rectal cancer surgery

Area of Science:

• Colorectal Surgery
• Surgical Techniques
• Oncology

Background:

• Anastomotic leakage (AL) is a significant complication after rectal resection.
• Choosing the appropriate anastomosis technique is crucial for patient outcomes.

Purpose of the Study:

• To compare the anastomotic leakage (AL) rates between single stapling (CSA) and double stapling (DSA) techniques in rectal cancer surgery.
• To evaluate the influence of surgical technique on AL and other clinical factors.

Main Methods:

• A study involving 100 consecutive rectal cancer patients undergoing rectal resection with primary anastomosis.
• Patients were divided into two groups based on the anastomosis technique: CSA and DSA.

Main Results:

• The overall clinical anastomotic leakage rate was 7% (7/100), with 6% in the CSA group and 8% in the DSA group.
• No significant difference in AL rates was observed between CSA and DSA techniques.
• Higher AL rates were noted in low anastomoses (≤7 cm) and in patients receiving preoperative long-course radiotherapy (15.4%).
• The DSA technique resulted in a significantly shorter mean operation time (127 min) compared to CSA (141 min).

Conclusions:

• Both CSA and DSA techniques are equally safe for rectal anastomosis regarding leakage rates.
• The DSA technique is recommended due to its advantages, including shorter operative times.
• Proximal diversion is advised for patients undergoing neoadjuvant treatment with low anastomoses to minimize AL risk.