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Double stapling technique for low anterior resection.

Z Cohen, E Myers, B Langer

    Diseases of the Colon and Rectum
    |April 1, 1983
    PubMed
    Summary
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    This study on low anterior resection for rectal cancer found the double stapling technique safe and effective, with no mortality and minimal early complications. The technique facilitates lower anastomoses and reduces fecal spillage during rectal cancer surgery.

    Area of Science:

    • Colorectal Surgery
    • Surgical Oncology
    • Gastroenterology

    Background:

    • Low anterior resection (LAR) is a standard surgical procedure for rectal cancer.
    • Stapled techniques aim to improve anastomosis outcomes and reduce complications.
    • The double stapling technique (DST) offers potential advantages in rectal surgery.

    Purpose of the Study:

    • To evaluate the safety and efficacy of the double stapling technique (TA 55 and EEA staplers) in low anterior resection for rectal cancer.
    • To assess postoperative outcomes, including complications and functional results.

    Main Methods:

    • A cohort of 26 patients (18 male, 8 female) underwent low anterior resection for rectal carcinoma.
    • The TA 55 stapler was used for the distal resection margin, and the EEA stapler for anastomosis.

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  • A standardized technique was employed, with a defunctioning colostomy used in only one case.

    • Main Results:

    • No mortality was observed in the study group.
    • Follow-up ranged from 2 to 16 months with no early recurrence.
    • Stapler-related complications occurred in 3 patients (1 anastomotic leak, 2 strictures).
    • Early functional issues (incontinence, soiling, urgency) affected 30% of patients but improved within 3 months.

    Conclusions:

    • The double stapling technique is a safe and effective method for low anterior resection in rectal cancer patients.
    • DST offers advantages such as facilitating lower anastomoses, avoiding purse-string sutures, and minimizing fecal spillage.
    • Preliminary results indicate good outcomes with acceptable complication rates.