Double Stapling Technique in Low Anterior Resection for Rectal Cancer

ABSTRACT

The double stapling technique has become an established reconstruction method for patients undergoing low anterior resection. We have used a modification of the conventional technique in which the lower rectal segment is closed with a linear stapler (TA-55) and the anastomosis is performed by using the circular EEA(CEEA) instrument across the linear staple line of the double stapling technique. The aim of this study was to evaluate the prophylactic effect of a loop ileostomy preventing anastomotic leakage. Stapled colorectal anastomosis and stapled coloanal anastomosis in 60 patients forms the basis for the report. The sixty patients were treated by using the double stapling technique either with or without a loop ileostomy. This review presents the advantages and disadvantages of a loop ileostomy for coloanal anastomosis. Postoperative anastomotic leakage in the double stapling technique group occurred in 5 (10.6%)cases of the total 31 cases while in the double stapling technique with loop ileostomy group, it allowed 1(3.4%) of the total 29 cases. This study suggests that the double stapling technique with a loop ileostomy is more effective than the double stapling technique without a loop ileostomy in preventing anastomotic leakage. The addition of a loop ileostomy to protect the low anastomosis might also be expected to influence anastomotic healing.