Colorectal eversion technique combined with modified single-stapled double-purse-string low colorectal anastomosis

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Gastrointestinal Surgery

Background:

• Total mesorectal excision (TME) is the standard for rectal cancer surgery.
• Challenges exist in achieving adequate distal margins in narrow pelves using linear staplers.
• The colorectal eversion technique with modified single-stapled double-purse-string anastomosis (SSDP) presents a potential solution.

Purpose of the Study:

• To evaluate the safety and reproducibility of the colorectal eversion technique combined with modified SSDP.
• To assess the feasibility of this technique in patients undergoing TME.
• To determine the oncological outcomes and complications associated with this approach.

Main Methods:

• A cohort of eleven patients underwent TME using the colorectal eversion technique and modified SSDP.
• Data collected included operative time, hospital stay, and postoperative complications.
• Histopathological analysis assessed resection margins and anastomotic integrity.

Main Results:

• No postoperative complications were observed.
• All patients achieved complete mesorectal resection with negative circumferential and distal resection margins.
• Histology confirmed negative anastomotic doughnuts, with no local recurrence or distant metastasis at 7 months follow-up.

Conclusions:

• The colorectal eversion technique with modified SSDP is a safe and reproducible surgical option for selected rectal surgery patients.
• This technique facilitates adequate margin achievement in challenging pelvic anatomies.
• Further prospective randomized trials are warranted to validate these preliminary findings in larger patient cohorts.