Results of the double stapling procedure in colorectal surgery |
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Authors: | Chuan-Gang Fu Tetsuichiro Muto Tadahiko Masaki |
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Institution: | (1) Department of Colorectal Surgery, Changhai Hospital, Second Military Medical University, Shanghai, P.R. China;(2) First Department of Surgery, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, 113 Tokyo, Japan |
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Abstract: | In this report we review our results with the double stapling technique (DST) in 162 patients with colorectal diseases in
an attempt to identify some of the potential pitfalls of this new technique. Among these 162 patients, there were 125 patients
with colorectal cancer, 25 with chronic ulcerative colitis (UC), 9 with familial adenomatous polyposis (FAP), 2 with adult
Hirschsprung's disease, and 1 with sigmoid colon fistula. A total of 46 anastomoses (28 for rectal cancer, 13 for UC, 3 for
FAP, and 2 for adult Hirschsprung's disease) were performed at or near the dentate line. Of these, 10 had protective diverting
colostomy or ileostomy. The results showed that 6 patients with rectal cancer had anastomotic leakage (3.7%); however, 4 of
the 6 patients had also received preoperative irradiation. All the leaks healed after the patients had undergone diverting
colostomy, but 7 patients with rectal cancer suffered from neurogenic bladder postoperatively (4.3%). Wound infection occurred
in 4 patients (2.5%), anastomotic bleeding in 3 (1.9%), and anal pain in 1 (0.6%), respectively. One patient with rectal cancer
and multiple liver metastases died of disseminated intravascular coagulation (DIC). These results thus suggest that the double
stapling technique provides a safe anastomosis at or near the dentate line not only for rectal cancer but also for UC, FAP,
and adult Hirschsprung's disease. |
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Keywords: | colorectal surgery double stapling rectal reconstruction |
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