Horizontal rectal transection using an endolinear stapler for laparoscopic low anterior resection

Hotta, Tsukasa; Takifuji, Katsunari; Yokoyama, Shozo; Matsuda, Kenji; Ieda, Junji; Watanabe, Takashi; Tamura, Koichi; Mitani, Yasuyuki; Iwamoto, Hisao; Takei, Yoh; Mizumoto, Yuki; Tsumura, Ayako; Deguchi, Masaaki; Yamaue, Hiroki

doi:10.1007/s10151-017-1617-9

Cited by 1 publication

(1 citation statement)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The incidence of symptomatic AL after AR has been reported variously between 6.3% and 13.2%. 2,5,6,[14][15][16] This proportion has gradually declined with the progress of surgical procedures and equipment, 14,17 but it is still far from 0%. In this study, the incidence of AL was high as 24%, but symptomatic AL (grade B+C) is 4 cases (16%), and it is considered to be equivalent to the reports to date.…”

Section: Discussionmentioning

confidence: 99%

Quantitative Indocyanine Green Fluorescence Imaging Used to Predict Anastomotic Leakage Focused on Rectal Stump During Laparoscopic Anterior Resection

Iwamoto

Matsuda

Hayami

et al. 2020

Journal of Laparoendoscopic & Advanced Surgical Techniques

View full text Add to dashboard Cite

Background: Anastomotic leakage (AL) is arguably the most troublesome complication of anterior resection (AR). In recent years, however, indocyanine green (ICG) fluorescence imaging has been recently used to evaluate blood flow in the anastomosis site, and it has been suggested that AL may be predicted. We reported the effectiveness of predicting AL in colorectal cancer surgery by observing a quantitative laparoscopic ICG fluorescence imaging for the first time. The purpose of this study was to predict the risk of postoperative AL by quantitative laparoscopic ICG fluorescence imaging focused on the rectal stamp, which is one of the major causes of AL in AR, and to construct diverting stoma (DS) only in appropriate cases. Methods: We studied the 25 patients who underwent elective laparoscopic AR for rectal cancer at our hospital between July 2016 and June 2017. Before enforcing double-stapling technique anastomosis, we injected ICG intravenously, and laparoscopically evaluated blood flow on the rectal stump. We analyzed quantitatively the relationship between various parameters and AL. Results: Median T0, from when the ICG was injected intravenously and the ICG disappeared from the injection route to the rise of the histogram of intensity, in AL group was significantly longer than that in non-AL group (P = .03). There were no other significant differences between AL and non-AL groups. Conclusions: T0 was longer in patients with AL than in those without. If prolonged T0 can be recognized intraoperatively, it will be possible to construct DS for appropriate patients only.

show abstract