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Single versus double stapling anastomotic technique in rectal cancer surgery.
MedLine Citation:
PMID:  23801054     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: The present study was designed to investigate whether there is a difference in the anastomotic leakage rate (AL) between the single stapling (CSA) and double stapling (DSA) anastomosis techniques.
METHODS: One hundred consecutive rectal cancer patients who underwent rectal resection with primary anastomosis were enrolled in this study.
RESULTS: The overall rate of clinical anastomotic leakage in both groups was 7 % (7/100); 6 % (3/50) in the CSA group and 8 % (4/50) in the DSA group. The anastomotic technique did not have any significant influence on the rate of AL. All AL were seen in low anastomoses (7 cm and below). The rate of AL in patients with a diverting stoma (13 %, 3/23) was not significantly different from that of the patients without (5.2 %, 4/77) (p = 0.195). The mean length of the operation was significantly shorter in the DSA group compared to the CSA group, at 127 and 141 min, respectively (p = 0.005). There were significantly higher rates of AL in patients receiving preoperative long course radiotherapy (15.4 %, 6/39) compared with those who did not receive radiotherapy (1.63 %, 1/61) (p = 0.014).
CONCLUSIONS: The CSA and DSA techniques are equally safe for the creation of a rectal anastomosis, without any significant difference in the AL rate. However, we recommend using the DSA technique because it has other definite advantages. In cases of neoadjuvant treatment and a low anastomosis, proximal diversion is recommended.
Authors:
Z Radovanovic; T Petrovic; D Radovanovic; M Breberina; A Golubovic; D Lukic
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-6-26
Journal Detail:
Title:  Surgery today     Volume:  -     ISSN:  1436-2813     ISO Abbreviation:  Surg. Today     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-6-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9204360     Medline TA:  Surg Today     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Surgical Oncology, Oncology Institute of Vojvodina, Put dr Goldmana 4, 21204, Sremska Kamenica, Serbia, radovanovic.zoran@onk.ns.ac.rs.
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