Double stapling technique in the management of rectal tumours

Before the circular stapling device was introduced, 25% of patients with rectal carcinoma underwent sphincter saving surgery. Stapling technique has been commonly used since 1980 and in the subsequent 5 years anterior resection was performed on 62% of patients treated for rectal carcinoma. "Single stapled" anastomosis, i.e. with a proximal and a distal purse-string suture, was performed in 33 cases, and in 22 cases a "double stapling" technique was used, i.e. the rectum was closed with a straight stapled suture and a circular anastomosis was then made through the stapled suture row of the closed rectum. No difference was found between the two stapling techniques regarding anastomotic dehiscence, pelvic abscess, postoperative fever, perioperative mortality or tendency to anastomotic stenosis. Among the patients with tumour 5-8 cm from the anal verge, a significantly higher proportion underwent a sphincter-preserving procedure with double stapling than with single stapling technique.