title: [Long-term follow-up of mechanical anastomoses in surgery of the large intestine. Prospective study of 683 patients].
abstract: The long-term results of colorectal and coloanal anastomoses using the EEA, SPTU and ILS circular staplers are reviewed. Anastomoses with these stapling devices were performed in 683 patients between September 1978 and April 1982. 91% of patients with rectal carcinoma underwent rectal resection and restoration of bowel continuity. All patients were operated on for the same way. We used a cancericidal rectal irrigation with 5.0% Sublimate (HgCl2) regularly in all patients with carcinoma. The inferior mesenteric artery is ligated and divided, preserving the arcade between the ascending and descending branch of the left colonic artery. The incidence of postoperative complications amounted to 17%. Intraoperative complications occurred in 12,7% (anastomotic leak 8%, difficult extraction 1,5%, bleeding 0,4%, instrument failure 2,8%). The incidence of dehiscence of anastomosis after low anterior resection (n = 422) was 15% and 3% after high anterior resection (n = 261). The clinical leakage in both groups was 4.2 and 2.3% respectively. Two of 23 patients died because of anastomotic leakage only .4 patients (1.3%) have been observed to develop a recurrent anastomotic tumour and 18 (5.8%) developed a recurrent pelvic tumour. To test the sphincter function after a very low colo-rectal anastomosis (3.5 to 5 cm from cutaneous-anal verge) 32 patients were examined by using manometric studies. There were no statistically differences between normal subjects and those patients in resting pressure, maximum squeeze pressure, and length of anal canal. A significantly lower rectal compliance and rectal capacity could be found.
mesh_terms: D000328:Adult; D000368:Aged; D003108:Colonic Diseases / Q000601:surgery*; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012002:Rectal Diseases / Q000601:surgery*; D013528:Surgical Staplers; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D014945:Wound Healing
vernacular_title: Langzeit- "Follow-up" von maschinellen Anastomosen in der Dickdarmchirurgie. Prospektive Studie bei 683 Patienten.