Experience with the Use of the Surgical Staplers in Rectal Cancer Surgery
Journal of the Korean Surgical Society
;
: 377-384, 1997.
Article
in Korean
| WPRIM
| ID: wpr-223160
ABSTRACT
The surgical stapling technique has been recognized as an indispensable tool in rectal cancer surgery. A personal experience in one-hundred patiens is presented for the purpose of appropriate use of the surgical staplers. Three anastomotic techniques used were end-to-end anastomosis in 75 cases, double-stapling in 11 cases, and side-to-end anastomosis in 14 cases. In 88 cases, level of anastomosis was below the peritoneal reflection. Eight cases of stapling errors were found during operation. Among them, 5 cases of instrumental failure were 2 cases of blade defect and each one of difficult extraction, misfiring or tearing over trocar. The other 3 cases of surgical errors come from uneven perirectal excision causing one incomplete doughnut and 2 deficient anastomosis. Distal resection margin was closely related to the location of tumor(p < 0.01), but local recurrence did not associated with it. Two cases of postoperative hematochezia showed self-limiting. Anastomotic leakage occurred in 3 female patients and they were converted into resection. Excluding one leakage from skipped proximal foci, 2 cases occurred in the ultra-low anastomosis. Postoperative stricture was found in 5 cases and they were not associated with internal diameter of circular stapler. They were treated by manual dilatation and bulk-forming laxatives without surgical intervention. Bowel frequency or inability of deferrment was found in 9 cases on 1 month and 5 cases on 6 months postoperatively. They were not related to anastomotic level or stapling method. In conclusion, the stapling technique in rectal cancer surgery is a safe as well as a comfortable technique whenever complication can be amenable to the surgeon.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Rectal Neoplasms
/
Recurrence
/
Surgical Instruments
/
Surgical Staplers
/
Surgical Stapling
/
Constriction, Pathologic
/
Medical Errors
/
Dilatation
/
Laxatives
/
Anastomotic Leak
Limits:
Female
/
Humans
Language:
Korean
Journal:
Journal of the Korean Surgical Society
Year:
1997
Type:
Article
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