Abstract

Aim: Law anterior resection (LAR) is a reliable surgical technique for the treatment of upper and mid-rectum cancers. With the development of technical equipment in recent years, more patients have the chance of LAR. We questioned the safety of colorectal anastomoses performed with stapling technique versus hand-suturing after LAR. Methods: Between the years of 1992 and 2001, 68 patients had LAR for adenocarcinorna of the upper and middle third of rectum. Twenty-five patients died during the fallow-up and 37 patients were included in the study. LAR was performed by hand suturing in 23 patients (62 %) and by 'double-stapling technique' in 14 (38%) patients. The final outcome of two methods were compared for incontinence, leakage and stricture of anastomosis. Results: Thirty-seven patients were followed up for a median period of 49 months (4-120 months). The two groups were similar for age, gender, and distance of tumor from the anal verge, stage, and tumor differentiation. Incomplete incontinence was found in 4 of the hand-sewn patients. One patient had complete, anather had incomplete incontinence in the stapler group. The two groups were found to be statistically similar in terms of incontinence, anastomotic leakage and stricture. Conclusion: We conclude that the 'double stapling technique' in the surgical resection of rectal carcinamas seems to be safe and an effective technique to avoid the development of incontinence, leakage and stricture of anastomosis.