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Published in:

01-12-2015

Efficacy of intracorporeal reinforcing sutures for anastomotic leakage after laparoscopic surgery for rectal cancer

Authors: Kiyoshi Maeda, Hisashi Nagahara, Masatsune Shibutani, Hiroshi Ohtani, Katsunobu Sakurai, Takahiro Toyokawa, Kazuya Muguruma, Hiroaki Tanaka, Ryosuke Amano, Kenjiro Kimura, Kenji Sugano, Teturo Ikeya, Yasuhito Iseki, Kosei Hirakawa

Published in: Surgical Endoscopy | Issue 12/2015

Abstract

Background

The aim of the present study was to investigate the efficacy of intracorporeal reinforcing sutures for preventing anastomotic leakage (AL) after laparoscopic surgery for rectal cancer.

Methods

This was a retrospective single-institution study consisting of 201 consecutive patients who underwent laparoscopic proctectomy with double-stapling anastomosis for primary rectal cancer between August 2007 and December 2013. The data for patients who received intracorporeal reinforcing sutures were compared with those of patients who did not receive reinforcing sutures. Patient-, tumor- and surgery-related variables were collected and examined using univariate and multivariate analyses.

Results

The overall incidence of AL was 9.0 % (18/201). No significant correlations were observed between the various clinicopathological factors and the use of reinforcing sutures. The multivariate analyses revealed the distance of the tumor from the anal verge, tumor size and presence of reinforcing sutures to be independent risk factors for AL. We classified the patients into two risk groups using a combination of the tumor site and tumor size: a low-risk group (patients without any risk factors, n = 134) and a high-risk group (patients with one or two risk factors, n = 67). The frequency of AL was significantly lower (p < 0.02) in the patients treated with reinforcing sutures than in those treated without reinforcing sutures in the high-risk group. However, no significant differences were observed in the low-risk group.

Conclusions

The use of intracorporeal reinforcing sutures may reduce the incidence of AL. A prospective randomized trial is required to evaluate the effects of reinforcing sutures in preventing AL.

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Title: Efficacy of intracorporeal reinforcing sutures for anastomotic leakage after laparoscopic surgery for rectal cancer
Authors: Kiyoshi Maeda
Hisashi Nagahara
Masatsune Shibutani
Hiroshi Ohtani
Katsunobu Sakurai
Takahiro Toyokawa
Kazuya Muguruma
Hiroaki Tanaka
Ryosuke Amano
Kenjiro Kimura
Kenji Sugano
Teturo Ikeya
Yasuhito Iseki
Kosei Hirakawa
Publication date: 01-12-2015
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 12/2015
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-015-4104-2

At a glance: The STEP trials

Springer Medicine

Efficacy of intracorporeal reinforcing sutures for anastomotic leakage after laparoscopic surgery for rectal cancer

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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