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.

Brisinda, G., Vanella, S., Cadeddu, F., Civello, I.M., Brandara, F., Nigro, C., et al. (2009). End-to-end versus end-to-side stapled anastomoses after anterior resection for rectal cancer. JOURNAL OF SURGICAL ONCOLOGY, 99(1), 75-79 [10.1002/jso.21182].

End-to-end versus end-to-side stapled anastomoses after anterior resection for rectal cancer

CADEDDU, FEDERICA;NIGRO, CASIMIRO;
2009

Abstract

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.
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/18 - Chirurgia Generale
English
Con Impact Factor ISI
Anterior resection; Rectal cancer; Total mesorectal excison
Brisinda, G., Vanella, S., Cadeddu, F., Civello, I.M., Brandara, F., Nigro, C., et al. (2009). End-to-end versus end-to-side stapled anastomoses after anterior resection for rectal cancer. JOURNAL OF SURGICAL ONCOLOGY, 99(1), 75-79 [10.1002/jso.21182].
Brisinda, G; Vanella, S; Cadeddu, F; Civello, I; Brandara, F; Nigro, C; Mazzeo, P; Marniga, G; Maria, G
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2108/35049
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