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Comparison of intracorporeal single-stapled and double-stapled anastomosis in laparoscopic low anterior resection for rectal cancer: a case–control study

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Abstract

Purpose

Recently, a single-stapled technique (SST) was performed instead of the conventional double-stapled technique (DST) in laparoscopic low anterior resection for anastomosis, by placement of intracorporeal purse-string sutures on the distal rectum with transanal specimen extraction. This study aimed to compare the short-term outcomes between the two anastomotic techniques.

Methods

Between July 2007 and April 2010, 60 patients underwent SST by laparoscopic or robotic procedure. These patients were matched 1:2 by age, gender, date of surgery, and tumor stage with 120 patients who underwent conventional DST in laparoscopic low anterior resection.

Results

The robotic-assisted operative approach was used more frequently in the SST group than in the DST group (61.7 % vs. 3.3 %, p < 0.001). The mean operative time was 203.9 (range, 120–400) min for the SST group and 167.6 (range, 90–300) min for the DST group (p < 0.001). For specimen removal, the transanal approach was used in the SST group, while the transabdominal approach was used for the DST group. The pain score (visual analogue scale) of the SST group was lower (4.5 vs. 5.6, p < 0.001), although postoperative recovery was similar. Pathological examination revealed that the distal resection margin was significantly longer in the SST group (3.1 vs. 2.5 cm, p = 0.018). Postoperative morbidity including anastomotic leakage was similar in both groups.

Conclusions

SST yielded equivalent short-term outcomes when compared to conventional DST and provided the advantages of minimal access and a longer distal resection margin. Therefore, SST in lower anterior resection may be a useful alternative to conventional DST.

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Acknowledgments

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MEST) 2011 (NO.2011-0011004).

Financial disclosure

Hye Jin Kim, Gyu-Seog Choi, Jun Seok Park, and Soo Yeun Park have no conflicts of interest or financial relationships to disclose.

Author contributions

Study design and writing of manuscript are attributed to Hye Jin Kim. Responsibility to correspondence and study proposal are attributed to Gyu-Seog Choi. Enrollment of patients is attributed to Gyu-Seog Choi and Jun Seok Park. Data collection and analysis are attributed to Soo Yeun Park.

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Authors and Affiliations

  1. Colorectal Cancer Center, Kyungpook National University Medical Center, School of Medicine, Kyungpook National University, 807, Hogukro, Buk-gu, Daegu, 702-210, South Korea

    Hye Jin Kim, Gyu-Seog Choi, Jun Seok Park & Soo Yeun Park

Authors
  1. Hye Jin Kim
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  2. Gyu-Seog Choi
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  3. Jun Seok Park
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  4. Soo Yeun Park
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Corresponding author

Correspondence to Gyu-Seog Choi.

Additional information

Presented and honored with a Karl Storz-EAES Award at the 20th International Congress of the EAES, Brussels, Belgium, 20–23 June 2012.

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Kim, H.J., Choi, GS., Park, J.S. et al. Comparison of intracorporeal single-stapled and double-stapled anastomosis in laparoscopic low anterior resection for rectal cancer: a case–control study. Int J Colorectal Dis 28, 149–156 (2013). https://doi.org/10.1007/s00384-012-1582-8

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  • DOI: https://doi.org/10.1007/s00384-012-1582-8

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