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L De Salvo1, F Razzetta, A Cagnazzo
1Istituto di Clinica Chirurgica Generale e Terapia Chirurgica, Università degli Studi di Genova.
Annali Italiani Di Chirurgia
|May 1, 1997
Summary
For rectal surgery, end-to-end stapled anastomosis is the safest and most reliable technique. This study found no complications with end-to-end stapling, unlike side-to-end or double stapling methods.
Area of Science:
- Colorectal Surgery
- Surgical Techniques
- Anastomosis
Background:
- Stapled anastomosis is commonly used in rectal surgery.
- Different stapling techniques exist, including end-to-end, side-to-end, and double stapling.
- The reliability and safety of these techniques can vary.
Purpose of the Study:
- To determine the most reliable stapled anastomosis technique in rectal surgery.
- To compare the incidence of complications associated with different stapling methods.
Main Methods:
- A randomized study involving 67 patients undergoing low anterior resection.
- Patients were assigned to three groups: end-to-end, side-to-end, or double stapling anastomosis.
- Outcomes measured included intraoperative and postoperative leakage, stenosis, mortality, and mean postoperative stay.
Main Results:
- End-to-end anastomosis showed no intra- or postoperative complications.
- Side-to-end anastomosis had a 19% intraoperative and 4.7% postoperative leakage rate, with one mortality.
- Double stapling resulted in 18.2% intraoperative and 22.7% postoperative leakage, 13.6% stenosis, and one mortality.
Conclusions:
- The end-to-end stapling technique is safer and more reliable for colorectal anastomoses.
- Other stapling methods are associated with higher complication rates.
- End-to-end anastomosis led to a shorter mean postoperative stay (13 days) compared to side-to-end (20 days) and double stapling (31 days).