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Can the Single-stapling Technique Following Intersphincteric Resection with Transanal Total Mesorectal Excision Become the New Standard Anastomosis?
For transanal total mesorectal excision (TaTME), the indication for single-stapling technique (SST) has been expanded to include lower anastomosis, even in intersphincteric resection (ISR). We focused on the anastomotic techniques following ISR with TaTME and examined the feasibility and safety of t...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Japan Society of Coloproctology
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10600260/ https://www.ncbi.nlm.nih.gov/pubmed/37900691 http://dx.doi.org/10.23922/jarc.2023-026 |
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author | Kitaguchi, Daichi Hasegawa, Hiro Ando, Koji Ikeda, Koji Tsukada, Yuichiro Nishizawa, Yuji Ito, Masaaki |
author_facet | Kitaguchi, Daichi Hasegawa, Hiro Ando, Koji Ikeda, Koji Tsukada, Yuichiro Nishizawa, Yuji Ito, Masaaki |
author_sort | Kitaguchi, Daichi |
collection | PubMed |
description | For transanal total mesorectal excision (TaTME), the indication for single-stapling technique (SST) has been expanded to include lower anastomosis, even in intersphincteric resection (ISR). We focused on the anastomotic techniques following ISR with TaTME and examined the feasibility and safety of the SST below the anorectal junction (ARJ). Data on postoperative anastomosis-related complications and anorectal function was evaluated in comparison to conventional manual hand-sewn coloanal anastomosis in ISR with TaTME. We examined patients with 3-6 cm tumors from the anal verge who underwent ISR with TaTME between January 2018 and March 2020, and whose anastomotic line was located below the ARJ. Postoperative short-term outcomes and anorectal functions were compared. We also analyzed the effects of various factors on major low anterior resection syndrome (LARS) using multivariate logistic regression analysis. In total, 87 patients-48 in the hand-sewn anastomosis group and 39 in the SST group-were included in this study. SST below the ARJ in ISR with TaTME did not exacerbate surgical outcomes, including anastomosis-related complications. The SST group had a significantly lower LARS score as compared to the hand-sewn anastomosis group, and the proportion of major LARS was significantly lower. Only hand-sewn anastomosis was identified as a statistically significant independent risk factor for major LARS. In TaTME, SST below the ARJ was safe and feasible and had a lower negative impact on postoperative anastomosis-related complications and anorectal function as compared to hand-sewn anastomosis. Thus, SST is a promising anastomotic option for patients with low-lying rectal tumors. |
format | Online Article Text |
id | pubmed-10600260 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | The Japan Society of Coloproctology |
record_format | MEDLINE/PubMed |
spelling | pubmed-106002602023-10-27 Can the Single-stapling Technique Following Intersphincteric Resection with Transanal Total Mesorectal Excision Become the New Standard Anastomosis? Kitaguchi, Daichi Hasegawa, Hiro Ando, Koji Ikeda, Koji Tsukada, Yuichiro Nishizawa, Yuji Ito, Masaaki J Anus Rectum Colon Review Article For transanal total mesorectal excision (TaTME), the indication for single-stapling technique (SST) has been expanded to include lower anastomosis, even in intersphincteric resection (ISR). We focused on the anastomotic techniques following ISR with TaTME and examined the feasibility and safety of the SST below the anorectal junction (ARJ). Data on postoperative anastomosis-related complications and anorectal function was evaluated in comparison to conventional manual hand-sewn coloanal anastomosis in ISR with TaTME. We examined patients with 3-6 cm tumors from the anal verge who underwent ISR with TaTME between January 2018 and March 2020, and whose anastomotic line was located below the ARJ. Postoperative short-term outcomes and anorectal functions were compared. We also analyzed the effects of various factors on major low anterior resection syndrome (LARS) using multivariate logistic regression analysis. In total, 87 patients-48 in the hand-sewn anastomosis group and 39 in the SST group-were included in this study. SST below the ARJ in ISR with TaTME did not exacerbate surgical outcomes, including anastomosis-related complications. The SST group had a significantly lower LARS score as compared to the hand-sewn anastomosis group, and the proportion of major LARS was significantly lower. Only hand-sewn anastomosis was identified as a statistically significant independent risk factor for major LARS. In TaTME, SST below the ARJ was safe and feasible and had a lower negative impact on postoperative anastomosis-related complications and anorectal function as compared to hand-sewn anastomosis. Thus, SST is a promising anastomotic option for patients with low-lying rectal tumors. The Japan Society of Coloproctology 2023-10-25 /pmc/articles/PMC10600260/ /pubmed/37900691 http://dx.doi.org/10.23922/jarc.2023-026 Text en Copyright © 2023 The Japan Society of Coloproctology https://creativecommons.org/licenses/by-nc-nd/4.0/Journal of the Anus, Rectum and Colon is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Review Article Kitaguchi, Daichi Hasegawa, Hiro Ando, Koji Ikeda, Koji Tsukada, Yuichiro Nishizawa, Yuji Ito, Masaaki Can the Single-stapling Technique Following Intersphincteric Resection with Transanal Total Mesorectal Excision Become the New Standard Anastomosis? |
title | Can the Single-stapling Technique Following Intersphincteric Resection with Transanal Total Mesorectal Excision Become the New Standard Anastomosis? |
title_full | Can the Single-stapling Technique Following Intersphincteric Resection with Transanal Total Mesorectal Excision Become the New Standard Anastomosis? |
title_fullStr | Can the Single-stapling Technique Following Intersphincteric Resection with Transanal Total Mesorectal Excision Become the New Standard Anastomosis? |
title_full_unstemmed | Can the Single-stapling Technique Following Intersphincteric Resection with Transanal Total Mesorectal Excision Become the New Standard Anastomosis? |
title_short | Can the Single-stapling Technique Following Intersphincteric Resection with Transanal Total Mesorectal Excision Become the New Standard Anastomosis? |
title_sort | can the single-stapling technique following intersphincteric resection with transanal total mesorectal excision become the new standard anastomosis? |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10600260/ https://www.ncbi.nlm.nih.gov/pubmed/37900691 http://dx.doi.org/10.23922/jarc.2023-026 |
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