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International Journal of Colorectal Disease

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01-07-2008 | Original Article

Relationship between multiple numbers of stapler firings during rectal division and anastomotic leakage after laparoscopic rectal resection

Authors: Masaaki Ito, Masanori Sugito, Akihiro Kobayashi, Yusuke Nishizawa, Yoshiyuki Tsunoda, Norio Saito

Published in: International Journal of Colorectal Disease | Issue 7/2008

Abstract

Background

We experienced some technical difficulty in dividing the middle and lower rectum through the right-lower quadrant intracorporeally. The aim of this study was to determine whether multiple stapler firings during rectal division are associated with anastomotic leakage after laparoscopic rectal resection.

Methods

Laparoscopic anterior resection with double-stapling technique anastomosis was performed in 180 consecutive rectal cancer patients. We often used vertical rectal division through a suprapubic site instead of the standard transverse rectal division for laparoscopic total mesorectal excision (LapTME). We attempted to determine whether there was an association between the number of stapler firings and procedures in rectal division. Moreover, we identified risk factors for anastomotic leakage after laparoscopic rectal resection by multivariate analysis.

Results

Anastomotic leakage occurred in 5% of the subjects of this study. Vertical rectal division through the suprapubic site after Lap TME required fewer staples than transverse division through the right-lower port and a smaller percentage of patients required three or more staples for vertical rectal division than for transverse division (15% vs. 45%, p = 0.03). In the multivariate analysis, TME and the number of staplers used for rectal division were the factors found to be associated with a significantly greater risk of subsequent leakage (odd’s ratio = 5.3; 95% CI 1.2–22.7 and odd’s ratio = 4.6; 95% CI 1.1–19.2).

Conclusion

TME and multiple stapler firings during distal rectal division were associated with anastomotic leakage after laparoscopic rectal resection. Vertical rectal division through a suprapubic site was a useful method of avoiding multiple stapler firings during laparoscopic TME.

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Title: Relationship between multiple numbers of stapler firings during rectal division and anastomotic leakage after laparoscopic rectal resection
Authors: Masaaki Ito
Masanori Sugito
Akihiro Kobayashi
Yusuke Nishizawa
Yoshiyuki Tsunoda
Norio Saito
Publication date: 01-07-2008
Publisher: Springer-Verlag
Published in: International Journal of Colorectal Disease / Issue 7/2008
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-008-0470-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Relationship between multiple numbers of stapler firings during rectal division and anastomotic leakage after laparoscopic rectal resection

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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