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A novel approach to lower rectal anastomosis: technique innovation and the preliminary report of twenty cases

Journal of Coloproctology, 2016-06, Vol.36 (2), p.80-85 [Peer Reviewed Journal]

Sociedade Brasileira de Coloproctologia ;2016 Sociedade Brasileira de Coloproctologia ;Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. ;This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. ;ISSN: 2237-9363 ;ISSN: 2317-6423 ;EISSN: 2317-6423 ;DOI: 10.1016/j.jcol.2016.03.006

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  • Title:
    A novel approach to lower rectal anastomosis: technique innovation and the preliminary report of twenty cases
  • Author: Alibakhshi, Abbas ; Jahangiri, Yosra ; Sirati, Fereydoun ; Jalali, Sayed Mahdi ; Nikdad, Mohammad Sadegh ; Abbasi, Arezou ; Afarideh, Mohsen
  • Subjects: Abordagem pull-through ; Anastomose retal baixa com grampos ; Cirurgia colorretal ; Colorectal surgery ; GASTROENTEROLOGY & HEPATOLOGY ; Gastroenterology and Hepatology ; Low rectal stapler anastomosis ; Original Article ; Pull-through ; SURGERY ; Transabdominal ; Transanal
  • Is Part Of: Journal of Coloproctology, 2016-06, Vol.36 (2), p.80-85
  • Description: Abstract Background and aims To describe a practical technique innovation (transanal ‘Pull-through’ approach) as a feasible, safe and effective alternative to the conventional transabdominal stapler low rectal anastomosis in lesions of minimal anatomical distinction from the adjacent intact mucosa. Material and methods Prospective case-series of patients with low rectal cancers, familial adenomatous polyposis (FAP) and ulcerative colitis undergoing Pull-through transection and very low rectal anastomosis using linear TA-90 noncutting stapler and circular stapler-cutter. Results In this series, twenty patients (11 men and 9 women) underwent proctectomy by the transanal Pull-through technique. Barring one of the patients that developed a pelvic abscess in the immediate postop follow-up, surgical procedure and the long-term follow-up period was uncomplicated with no critical findings of leakage, stenosis and bleeding. The postop rate of infection and fecal incontinence was not significantly different between genders and different age groups of the study. The mean operative time was calculated 169.9 ± 11.1 minutes. Conclusion Pull-through transection procedure using the TA-90 non-cutting stapler is a safe, efficient and economically sound technique implicated in low-lying rectal lesions. The transanal ‘Pull-through’ approach is particularly helpful in situations where the direct visualization of lower rectal mucosa changes the prognosis through determining the marginal extent of intact/involved mucosa (e.g., FAP, villous adenomas, rectal polyps and post-neoadjuvant chemoradiotherapy tumors).
  • Publisher: Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil: Elsevier Editora Ltda
  • Language: English;Portuguese
  • Identifier: ISSN: 2237-9363
    ISSN: 2317-6423
    EISSN: 2317-6423
    DOI: 10.1016/j.jcol.2016.03.006
  • Source: SciELO
    DOAJ Directory of Open Access Journals
    Thieme Connect Journals Open Access
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