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Erschienen in: International Journal of Colorectal Disease 1/2013

01.01.2013 | Original Article

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

verfasst von: Hye Jin Kim, Gyu-Seog Choi, Jun Seok Park, Soo Yeun Park

Erschienen in: International Journal of Colorectal Disease | Ausgabe 1/2013

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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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Metadaten
Titel
Comparison of intracorporeal single-stapled and double-stapled anastomosis in laparoscopic low anterior resection for rectal cancer: a case–control study
verfasst von
Hye Jin Kim
Gyu-Seog Choi
Jun Seok Park
Soo Yeun Park
Publikationsdatum
01.01.2013
Verlag
Springer-Verlag
Erschienen in
International Journal of Colorectal Disease / Ausgabe 1/2013
Print ISSN: 0179-1958
Elektronische ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-012-1582-8

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