Low anterior resection with transanal transection and single-stapled anastomosis: technical aspects and initial results

Background Rectal cancer (RC) is a surgical challenge due to its technical complexity. The double-stapled (DS) technique, a standard for colorectal anastomosis, has been associated with notable drawbacks, including a high incidence of anastomotic leak (AL). Low anterior resection with transanal tran...

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Bibliographic Details
Published in:International journal of colorectal disease 2024-06, Vol.39 (1), p.85
Main Authors: Vivas López, Alfredo, Villar, Oscar Garcia, Borda, Javier Garcia, Restrepo Nuñez, Rafael, Rubio, Eduardo, Nevado, Cristina, Pelaez, Pablo, Labalde Martinez, Maria, Alias, David, Falcon, Kleber, Lorenzo, Sofia, Perea García, José, Ferrero, Eduardo
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Anal Canal - surgery
Anastomosis, Surgical - methods
Anastomotic Leak - etiology
Anastomotic Leak - prevention & control
Female
Gastroenterology
Hepatology
Humans
Internal Medicine
Laparoscopy - methods
Male
Medicine
Medicine & Public Health
Middle Aged
Proctology
Rectal Neoplasms - surgery
Rectum - surgery
Surgery
Surgical Stapling - methods
Treatment Outcome
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Summary:Background Rectal cancer (RC) is a surgical challenge due to its technical complexity. The double-stapled (DS) technique, a standard for colorectal anastomosis, has been associated with notable drawbacks, including a high incidence of anastomotic leak (AL). Low anterior resection with transanal transection and single-stapled (TTSS) anastomosis has emerged to mitigate those drawbacks. Methods Observational study in which it described the technical aspects and results of the initial group of patients with medium-low RC undergoing elective laparoscopic total mesorectal excision (TME) and TTSS. Results Twenty-two patients were included in the series. Favourable postoperative outcomes with a median length of stay of 5 days and an AL incidence of 9.1%. Importantly, all patients achieved complete mesorectal excision with tumour-free margins, and no mortalities were reported. Conclusion TTSS emerges as a promising alternative for patients with middle and lower rectal tumours, offering potential benefits in terms of morbidity reduction and oncological integrity compared with other techniques.
ISSN:1432-1262
0179-1958
1432-1262
DOI:10.1007/s00384-024-04646-3