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Related Experiment Video

Updated: Jul 5, 2026

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
09:40

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function

Published on: April 17, 2020

Single-stapling versus double-stapling technique for rectal anastomosis-meta-analysis.

Dimitrios Kehagias1, Charalampos Lampropoulos2, Ioannis Kehagias3

  • 1John Goligher Colorectal Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK.

BJS Open
|July 3, 2026
PubMed
Summary
This summary is machine-generated.

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The single-stapling technique (SST) shows a lower risk of anastomotic leak (AL) compared to the double-stapling technique (DST). This benefit is mainly observed with transanal SST, though evidence certainty is low.

Area of Science:

  • Colorectal surgery
  • Surgical techniques
  • Gastrointestinal oncology

Background:

  • The double-stapling technique (DST) is standard for low rectal surgery.
  • The single-stapling technique (SST) offers an alternative.
  • Anastomotic leak (AL) is a significant complication in rectal surgery.

Purpose of the Study:

  • To compare the risk of anastomotic leak (AL) between single-stapling technique (SST) and double-stapling technique (DST).
  • To evaluate secondary outcomes including blood loss, operative time, and length of hospital stay.
  • To assess the impact of surgical approach on AL rates.

Main Methods:

  • Systematic review and random-effects meta-analysis of PubMed/MEDLINE, Google Scholar®, and Scopus databases.
  • Included 14 studies (2 RCTs, 12 observational) with 1326 patients in SST group and 1720 in DST group.
Keywords:
anastomotic leakrectal cancertransanal transection and single-stapled anastomosis (TTSS)

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Last Updated: Jul 5, 2026

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
09:40

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function

Published on: April 17, 2020

The C-seal: A Biofragmentable Drain Protecting the Stapled Colorectal Anastomosis from Leakage
07:51

The C-seal: A Biofragmentable Drain Protecting the Stapled Colorectal Anastomosis from Leakage

Published on: November 4, 2010

  • Assessed risk of bias and certainty of evidence using GRADE framework.

    • Main Results:

    • SST was associated with a significantly lower risk of AL than DST (RR 0.61; P=0.012).
    • Transanal SST showed a pronounced reduction in AL compared to DST.
    • Minimally invasive intracorporeal SST showed a trend toward benefit over DST.

    Conclusions:

    • Single-stapling technique (SST) is associated with a reduced risk of anastomotic leak (AL) compared to double-stapling technique (DST).
    • The benefit of SST in reducing AL is primarily driven by the transanal approach.
    • Further prospective studies are needed to confirm findings due to low certainty of evidence.