[The EEA stapler in low rectal anastomoses: preliminary results (author's transl)]

In the past two years, we have been using the EEA stapler for anastomoses of the extra-peritoneal rectum. With this technique, we have been able to preserve the anal sphincter in all cases of tumor at or above 6 cm from the anal verge. The results of 24 consecutive cases demonstrate the safety of the mechanical anastomoses of the mid-rectum with no death, nor anastomotic dehiscence in 15 cases. Complications occurred in the lowest locations which would have been otherwise treated by an abdomino-perineal excision or pull through procedure: 1 death from peritonitis and stress ulcer 3 temporary leaks and 3 stenoses, easily treated by digital dilatation. The potential danger of anastomotic leaks justifies in the very low anastomoses a temporary colostomy : healing then occurs after a few weeks. The final result is an intact anatomy and sphincteric function.