A novel approach to lower rectal anastomosis: technique innovation and the preliminary report of twenty cases

Journal of Coloproctology - Tập 36 - Trang 80-85 - 2016
Abbas Alibakhshi1, Yosra Jahangiri1, Fereydoun Sirati1, Sayed Mahdi Jalali1, Mohammad Sadegh Nikdad1, Arezou Abbasi1, Mohsen Afarideh1
1Department of General Surgery, Imam Khomeini Hospital Complex (IKHC), Tehran University of Medical Sciences, Tehran, Iran

Tóm tắt

Abstract Background and aims To describe a practical technique innovation (transanal ‘Pull-through’ approach) as a feasible, safe and effective alternative to the conventional transabdominal stapler low rectal anastomosis in lesions of minimal anatomical distinction from the adjacent intact mucosa. Material and methods Prospective case-series of patients with low rectal cancers, familial adenomatous polyposis (FAP) and ulcerative colitis undergoing Pull-through transection and very low rectal anastomosis using linear TA-90 noncutting stapler and circular stapler-cutter. Results In this series, twenty patients (11 men and 9 women) underwent proctectomy by the transanal Pull-through technique. Barring one of the patients that developed a pelvic abscess in the immediate postop follow-up, surgical procedure and the long-term follow-up period was uncomplicated with no critical findings of leakage, stenosis and bleeding. The postop rate of infection and fecal incontinence was not significantly different between genders and different age groups of the study. The mean operative time was calculated 169.9 ± 11.1 minutes. Conclusion Pull-through transection procedure using the TA-90 non-cutting stapler is a safe, efficient and economically sound technique implicated in low-lying rectal lesions. The transanal ‘Pull-through’ approach is particularly helpful in situations where the direct visualization of lower rectal mucosa changes the prognosis through determining the marginal extent of intact/involved mucosa (e.g., FAP, villous adenomas, rectal polyps and post-neoadjuvant chemoradiotherapy tumors).

Tài liệu tham khảo

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Journal of Coloproctology

Tập 36

80-85

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