2011
DOI: 10.1016/j.ejso.2010.12.008
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Delayed colo-anal anastomosis is an alternative to prophylactic diverting stoma after total mesorectal excision for middle and low rectal carcinomas

Abstract: The trans-anal pull-through procedure after TME, followed by DCA seems to be a safe and efficient sphincter-preserving procedure to treat patients with middle or low rectal cancer while avoiding a prophylactic, diverting stoma.

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Cited by 56 publications
(64 citation statements)
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“…in addition, either a delayed anastomosis with creation of a direct Caa 5 to 7 days after redo surgery or a soave procedure (ie, straight Caa through the rectal stump after rectal mucosectomy) was used according to local conditions and difficulties for the pelvic dissection. 15 the level of transection of the rectum (CRa or Caa) depended on local conditions and surgical history. a defunctioning ileostomy was routinely performed at the end of redo surgery and reversal was planned for 2 or 3 months later, after ensuring the absence of anastomotic leakage with a water-soluble enema.…”
Section: Patientsmentioning
confidence: 99%
“…in addition, either a delayed anastomosis with creation of a direct Caa 5 to 7 days after redo surgery or a soave procedure (ie, straight Caa through the rectal stump after rectal mucosectomy) was used according to local conditions and difficulties for the pelvic dissection. 15 the level of transection of the rectum (CRa or Caa) depended on local conditions and surgical history. a defunctioning ileostomy was routinely performed at the end of redo surgery and reversal was planned for 2 or 3 months later, after ensuring the absence of anastomotic leakage with a water-soluble enema.…”
Section: Patientsmentioning
confidence: 99%
“…When the surplus colon below the anastomosis decayed and shed, the pull-though colon and anal canal had already started to adhere circumferentially. Its advantage in avoiding a diverting ileostomy was validated by another recent study (27). This procedure was much more acceptable because it was safe and facilitated timely receipt of chemotherapy.…”
Section: Discussionmentioning
confidence: 89%
“…Of 24 patients who underwent DCA without fecal diversion, no anastomotic leak was reported, and 1 patient experienced anastomotic stenosis. In 2011, Jarry and colleagues 7 reported 2% leak and 6% pelvic abscess rates with DCA performed for primary management of distal rectal car cinoma. The only other cohort con sidering DCA for salvage purposes was reported by Remzi and colleagues 5 as a prospective case-matched study comparing a mixed cohort of 44 patients undergoing salvage and primary DCA to 88 patients undergoing immediate anastomosis.…”
Section: Discussionmentioning
confidence: 99%
“…Overall, fair to good function has been suggested with DCA, depending on the scale used for measures. 5,[7][8][9] Unfortunately, no functional data were prospectively collected in our cohort. None of our patients required a new fecal diversion for poor function.…”
Section: Discussionmentioning
confidence: 99%
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