Curative potential of EEA stapler in rectal carcinoma

In a 5-year period (1980-1984), 96 patients were curatively treated for rectal carcinoma. Surgery consisted of local excision in 9 cases, resection with restoration of rectal continuity in 48 (the anastomosis EEA-stapled in 29 and hand-sewn in 19) and total rectal excision in 39 cases. These procedures were selected according to conventional principles, in non-randomized manner. Tumor stages were comparable in the groups with major surgery. After follow-up averaging 3 years, the crude survival rate was 76% in the EEA group, 53% after hand-sewn anastomosis and 69% after total rectal excision. Although the groups were not strictly comparable, the results showed that survival after low stapled anastomosis was not inferior to that after other treatment methods. Pelvic recurrence after stapling has so far appeared only in stage C cases. The study did not confirm recent alarming reports of high local recurrence risk after stapling. It supports the view that circular staplers permit preservation of sphincter without increased incidence of pelvic recurrence or compromised survival.