Laparoscopic intersphincteric resection for low rectal cancer: comparison of stapled and manual coloanal anastomosis

Jc, Cong; Cs, Chen; Mx, Ma; Zx, Xia; Liu, DS; Fy, Zhang

doi:10.1111/codi.12573

Cited by 48 publications

(37 citation statements)

References 19 publications

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“…Many previous studies have been reported which describe satisfactory outcomes in terms of oncological safety, morbidity and low levels of defaecatory dysfunction . The overall mortality rate reported in the literature for taTME/TATA is 0.8%, and the morbidity rate is approximately 25% . Early complications include anastomotic leakage, wound infection, bleeding, ileus, bowel obstruction, urinary infection, lung atelectasis and pelvic sepsis.…”

Section: Introductionmentioning

confidence: 98%

Full‐thickness neorectal prolapse after transanal transabdominal proctosigmoidectomy for low rectal cancer: a cohort study

2018

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Section: Introductionmentioning

confidence: 98%

Full‐thickness neorectal prolapse after transanal transabdominal proctosigmoidectomy for low rectal cancer: a cohort study

2018

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“…This procedure involves resection of part of, or the entire, internal sphincter and restoration of bowel continuity while obtaining sufficient distal margins. Laparoscopic ISR is associated with less surgical trauma, improved immediate postoperative outcomes and shorter recovery times compared with conventional open surgery, but similar long‐term oncological outcomes. Laparoscopy offers an optimal pelvic dissection with the visceral pelvic fascia remaining intact, and an enhanced view deeper within the pelvis than in the open technique.…”

Section: Introductionmentioning

confidence: 99%

Multicentre study of robotic intersphincteric resection for low rectal cancer

Park

Kim

et al. 2015

British Journal of Surgery

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“…In addition, although the cohort included both patients who had a stoma at the time of initial surgery and those in whom it was performed as part of an emergency procedure there was no difference in the risk of recurrent leakage between these groups. Previous studies have suggested that hand‐sewn coloanal anastomosis shows a higher incidence of anastomotic stricture than stapled CAA . However, in an updated Cochrane review of nine randomized controlled trials with a total of 1233 patients (622 stapled and 611 hand‐sewn) with colorectal anastomosis, Neutzling et al .…”

Section: Discussionmentioning

confidence: 99%

Recurrence of rectal anastomotic leakage following stoma closure: assessment of risk factors

et al. 2019

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Aim In patients with a previous history of rectal anastomotic leakage (AL), the surgical indications and timing for closure of a diverting stoma have to be carefully judged. Even if AL has apparently healed before stoma closure, re‐leakage may occur after closure. The aim of this study was to determine the incidence and risk factors for recurrent AL following stoma closure. We also examined the treatment strategies aiming to minimize the risk of recurrent AL. Methods From January 2009 to December 2016, 1008 patients underwent sphincter‐saving surgery [low anterior resection, all‐sphincter‐preserving rectal resection with hand‐sewn coloanal anastomosis (CAA) and intersphincteric resection (ISR)] for primary rectal cancer with curative intent at our hospital. A total of 69 patients with AL with a Clavien–Dindo Grade III or more who subsequently underwent closure of a diverting stoma were retrospectively reviewed for this study. Results The incidence of recurrent leakage after stoma closure in this series was 13% overall with an incidence of 25% in the CAA/ISR group and 5% in the low anterior resection group. Significant risk factors included hand‐sewn anastomosis (P = 0.0257) compared to stapled anastomosis, ischaemia at the anastomotic site as the cause of initial AL (P < 0.001) and a shorter interval between confirmation of healing and stoma closure (P = 0.00952). Conclusion Ischaemia at the anastomotic site was the main risk factor for recurrent leakage, particularly after CAA/ISR. Additional treatment options before stoma closure should be considered to avoid re‐leakage in such cases.

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Laparoscopic intersphincteric resection for low rectal cancer: comparison of stapled and manual coloanal anastomosis

Abstract: Laparoscopic intersphincteric resection with a stapled coloanal anastomosis is technically feasible and is less likely to result in anastomotic leakage and stricture formation than a hand-sewn anastomosis.

Cited by 48 publications

References 19 publications

Full‐thickness neorectal prolapse after transanal transabdominal proctosigmoidectomy for low rectal cancer: a cohort study

Full‐thickness neorectal prolapse after transanal transabdominal proctosigmoidectomy for low rectal cancer: a cohort study

Multicentre study of robotic intersphincteric resection for low rectal cancer

Recurrence of rectal anastomotic leakage following stoma closure: assessment of risk factors

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