Skip to main content
Top
Published in: Langenbeck's Archives of Surgery 4/2022

16-01-2022 | Rectal Cancer | How-I-Do-It articles

A stent-based diverting technique after low anterior resection of rectal cancer: our preliminary experience

Authors: Zhangfa Song, Xuefeng Huang, Sheng Dai, Yifan Tong, Xiujun Cai

Published in: Langenbeck's Archives of Surgery | Issue 4/2022

Login to get access

Abstract

Background

Anastomotic leakage (AL) is a severe complication of rectal cancer low anterior resection (LAR). Ileostomy, the most common method to reduce the severity of AL, is associated with the risk of permanent stoma and an additional operation for stoma reversal. This purpose of this study is to develop a novel protective technique called the stent-based diverting technique (SDT) to protect the anastomosis following LAR.

Methods

From March 2020 to December 2020, thirty-four patients treated with LAR followed by SDT were enrolled prospectively at Sir Run Run Shaw Hospital. Demographic characteristics, laboratory test results, surgical outcomes, and oncological features were recorded.

Results

Overall, the median period of stent degradation was 21 (18–24) days. One patient (2.9%) had anastomotic leakage, and another patient (2.9%) had intestinal obstruction, while no other complications (e.g., intestinal volvulus, perforation, fistula) were observed in this study.

Conclusions

The unique SDT may be a novel approach to prevent anastomotic leakage following low anterior resection of rectal cancer.
Literature
1.
go back to reference DF, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424. DF, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.
2.
go back to reference Borstlap WA, Westerduin E, Aukema TS et al (2017) Anastomotic leakage and chronic presacral sinus formation after low anterior resection: results from a large cross-sectional study. Ann Surg 266(5):870–877CrossRef Borstlap WA, Westerduin E, Aukema TS et al (2017) Anastomotic leakage and chronic presacral sinus formation after low anterior resection: results from a large cross-sectional study. Ann Surg 266(5):870–877CrossRef
3.
go back to reference Jung SH, Yu CS, Choi PW et al (2008) Risk factors and oncologic impact of anastomotic leakage after rectal cancer surgery. Dis Colon Rectum 51(6):902–908CrossRef Jung SH, Yu CS, Choi PW et al (2008) Risk factors and oncologic impact of anastomotic leakage after rectal cancer surgery. Dis Colon Rectum 51(6):902–908CrossRef
4.
go back to reference Wang S, Liu J, Wang S et al (2017) Adverse effects of anastomotic leakage on local recurrence and survival after curative anterior resection for rectal cancer: a systematic review and meta-analysis. World J Surg 41(1):277–284CrossRef Wang S, Liu J, Wang S et al (2017) Adverse effects of anastomotic leakage on local recurrence and survival after curative anterior resection for rectal cancer: a systematic review and meta-analysis. World J Surg 41(1):277–284CrossRef
5.
go back to reference Mrak K, Uranitsch S, Pedross F et al (2016) Diverting ileostomy versus no diversion after low anterior resection for rectal cancer: a prospective, randomized, multicenter trial. Surgery 159(4):1129–1139CrossRef Mrak K, Uranitsch S, Pedross F et al (2016) Diverting ileostomy versus no diversion after low anterior resection for rectal cancer: a prospective, randomized, multicenter trial. Surgery 159(4):1129–1139CrossRef
6.
go back to reference Chen H, Cai HK, Tang YH (2018) An updated meta-analysis of transanal drainage tube for prevention of anastomotic leak in anterior resection for rectal cancer. Surg Oncol 27(3):333–340CrossRef Chen H, Cai HK, Tang YH (2018) An updated meta-analysis of transanal drainage tube for prevention of anastomotic leak in anterior resection for rectal cancer. Surg Oncol 27(3):333–340CrossRef
7.
go back to reference Hüser N, Michalski CW, Erkan M et al (2008) Systematic review and meta analysis of the role of defunctioning stoma in low rectal cancer surgery. Ann Surg 248(1):52–60CrossRef Hüser N, Michalski CW, Erkan M et al (2008) Systematic review and meta analysis of the role of defunctioning stoma in low rectal cancer surgery. Ann Surg 248(1):52–60CrossRef
8.
go back to reference Bonjer HJ, Deijen CL, Abis GA et al (2015) A randomized trial of laparoscopic versus open surgery for rectal cancer. N Engl J Med 372(14):1324–1332CrossRef Bonjer HJ, Deijen CL, Abis GA et al (2015) A randomized trial of laparoscopic versus open surgery for rectal cancer. N Engl J Med 372(14):1324–1332CrossRef
9.
go back to reference Nuh NR, Jürgen W, Werner H et al (2010) Definition and grading of anastomotic leakage following anterior resection of the rectum: a proposal by the International Study Group of Rectal Cancer. Surgery 147(3):339–351CrossRef Nuh NR, Jürgen W, Werner H et al (2010) Definition and grading of anastomotic leakage following anterior resection of the rectum: a proposal by the International Study Group of Rectal Cancer. Surgery 147(3):339–351CrossRef
10.
go back to reference Chen MY, Cao JS, Huang DY et al (2019) End-to-end intestinal anastomosis using a novel biodegradable stent for laparoscopic colonic surgery: a multicenter study. Surg Today 49(12):1003–1012CrossRef Chen MY, Cao JS, Huang DY et al (2019) End-to-end intestinal anastomosis using a novel biodegradable stent for laparoscopic colonic surgery: a multicenter study. Surg Today 49(12):1003–1012CrossRef
11.
go back to reference Sparreboom CL, Groningen JT, Lingsma HF et al (2018) Different risk factors for early and late colorectal anastomotic leakage in a nationwide audit. Dis Colon Rectum 61(11):1258–1266CrossRef Sparreboom CL, Groningen JT, Lingsma HF et al (2018) Different risk factors for early and late colorectal anastomotic leakage in a nationwide audit. Dis Colon Rectum 61(11):1258–1266CrossRef
Metadata
Title
A stent-based diverting technique after low anterior resection of rectal cancer: our preliminary experience
Authors
Zhangfa Song
Xuefeng Huang
Sheng Dai
Yifan Tong
Xiujun Cai
Publication date
16-01-2022
Publisher
Springer Berlin Heidelberg
Published in
Langenbeck's Archives of Surgery / Issue 4/2022
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-022-02433-8

Other articles of this Issue 4/2022

Langenbeck's Archives of Surgery 4/2022 Go to the issue