Sphincter-saving resection of the rectum using the EEA autostapler.
Low anterior resection for carcinoma in the mid- and lower third of the rectum has been performed with autosuture technique, using the EEA autosuture stapling instrument in 38 patients, 26 with carcinoma, 10 with diverticulitis, and 2 with Crohn's disease. In 16 patients the anastomotic line was 4-6 cm above the anal verge, and in 22 patients 7-12 cm above the anal verge. Thirty-two patients (80%) had an uneventful postoperative course. Four patients had complications: one, with leakage from a very low-seated anastomosis, was treated with an abdominoperineal resection; 2 had temporary transversostomy performed due to minor anastomotic leakage; and 1 patient developed a fistula, which closed spontaneously. Two patients died, 1 from pulmonary embolism, 1 from cerebral thrombosis. The EEA stapling instrument seems safe, and approximately 42% of the patients in this material would formerly have been subjected to abdominoperineal resection and permanent colostomy.
D000328:Adult; D000368:Aged; D001003:Anal Canal; D003424:Crohn Disease / Q000601:surgery*; D004238:Diverticulitis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012002:Rectal Diseases / Q000601:surgery*; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D013528:Surgical Staplers; D013536:Suture Techniques