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- Title
Intra-operative double-stapled colorectal or coloanal anastomotic complications of laparoscopic low anterior resection for rectal cancer: double-stapled anastomotic complication could result in persistent anastomotic leakage.
- Authors
Kim, Ji; Kim, Ho; Lee, In; Oh, Seung; Kim, Jun; Lee, Yoon; Kim, Ji Hoon; Kim, Ho Young; Lee, In Kyu; Oh, Seung Teak; Kim, Jun Gi; Lee, Yoon Suk
- Abstract
<bold>Background: </bold>Laparoscopic surgery for rectal cancer is technically demanding and can be hindered by unexpected intra-operative complications. Among the various intra-operative complications, double-stapled anastomotic complications are more serious and complicated to manage. The purpose of this study is to analyze the impact of intra-operative double-stapled colorectal or coloanal anastomotic complications on short-term surgical outcomes and persistent leak, and risk factors of intra-operative double-stapled anastomotic complication.<bold>Methods: </bold>Consecutive 363 cases of laparoscopic low anterior resection from August 2004 to November 2012 were analyzed in this study. We retrospectively reviewed intra-operative double-stapled anastomotic complications and compared patient characteristics, surgical data, post-operative clinical data, and pathological data between groups with and without intra-operative double-stapled anastomotic complications. And we analyzed risk factors for double-stapled anastomotic complication.<bold>Results: </bold>There were 20 intra-operative double-stapled anastomotic complications among the patients (5.5 %). Operation time was longer (304.8 ± 122.0 vs. 197.1 ± 87.5 min, p = 0.001) and more diversion ileostomy were made (75 vs. 34.7 %, p < 0.001) in the group with double-stapled anastomotic complications. There were no differences in terms of surgical morbidity, conversion rate, anastomotic leakage, and hospital stay. However, there was more persistent anastomotic leakage (15 vs. 0.9 %, p = 0.003) in the group with double-stapled anastomotic complications. In univariate analysis, risk factors for double-stapled anastomotic complications were male, T4 stage lesion, and three or more stapler firings.<bold>Conclusions: </bold>The double-stapled anastomotic complications during laparoscopic low anterior resection increased operation time and rate of diversion ileostomy. Although these factors did not adversely affect short-term surgical outcome including post-operative morbidity and anastomotic leakage, double-stapled anastomotic complications could increase persistent anastomotic leakage rate.
- Subjects
RECTAL cancer treatment; LAPAROSCOPIC surgery; ILEOSTOMY; SURGICAL complications; SURGICAL anastomosis; HEALTH outcome assessment; COLON surgery; RECTAL surgery; COLON tumors; LAPAROSCOPY; RECTUM tumors; SUTURES; SUTURING; RETROSPECTIVE studies
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2015, Vol 29, Issue 11, p3117
- ISSN
1866-6817
- Publication type
journal article
- DOI
10.1007/s00464-014-4035-3