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End‐to‐end versus end‐to‐side stapled anastomoses after anterior resection for rectal cancer
Author(s) -
Brisinda Giuseppe,
Vanella Serafino,
Cadeddu Federica,
Civello Ignazio Massimo,
Brandara Francesco,
Nigro Casimiro,
Mazzeo Pasquale,
Marniga Gaia,
Maria Giorgio
Publication year - 2008
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21182
Subject(s) - medicine , anastomosis , surgery , anal verge , colorectal cancer , leak , colostomy , roux en y anastomosis , cancer , weight loss , environmental engineering , engineering , gastric bypass , obesity
Background and Aims Sphincter‐saving procedures for resection of mid and, in some cases, of distal rectal tumors have become prevalent as their safety have been established. Increased anastomotic leak rate, associated with the type of anastomosis and the distance from the anal verge, has been reported. To compare surgical outcomes of end‐to‐end and end‐to‐side anastomosis after anterior resection for T1–T2 rectal cancer. Methods During the study period, a total of 298 rectal cancer patients were treated. Patients with T1–T2 rectal cancer (i.e., tumor level ≤15 cm from the anal verge) fit for surgery were asked to participate in the study. Patients were randomized to receive either an end‐to‐end anastomosis or an end‐to‐side anastomosis using the left colon. Surgical results and complications were recorded. Results Seventy‐seven patients were randomized. Thirty‐seven end‐to‐end anastomoses and 40 end‐to‐side anastomoses were performed. Anastomotic leakage after end‐to‐end anastomosis was 29.2%, while after end‐to‐side anastomosis was 5% ( P = 0.005). In the end‐to‐end group 11 patients had anastomotic leaks: nine patients needed a re‐intervention with colostomy creation subsequently closed in seven cases. Two patients of the end‐to‐side group experienced anastomotic leakage and were successfully treated conservatively. Conclusions Regarding postoperative surgical complications, end‐to‐side anastomosis is a safe procedure. J. Surg. Oncol. 2009;99:75–79. © 2008 Wiley‐Liss, Inc.