Recurrent carcinoma after low anterior resection of the rectum using the EEA staple gun

In a consecutive series of 35 patients with colorectal carcinoma, low anterior rectal resection was performed, using the EEA staple gun. After a median observation time of 28 months, 7 (20%) of the patients were found to have local recurrence of cancer. The importance of tumor growth into the nerves and/or vessels was emphasized by the significantly higher incidence of local recurrence and/or distant metastases in such patients (10/12) than in patients without this involvement (6/23). An apparently increased incidence of local recurrence after stapled rectal anastomosis and possible mechanisms are discussed.