title: Low anterior resection without defunctioning stoma.
abstract: The aim of our study was to determine the anastomotic leakage rate after the performance of low anterior resection without protective stoma. During the time period from 1989 to 2001, 82 consecutive patients underwent low anterior resection for rectal carcinoma without protective stoma. Thirteen anastomoses were hand sewn (15.8%) and the remaining 69 (84.2%) were constructed with the use of a circular stapling gun. The mean distance of the anastomoses from the anal margin was 6.2 cm (range, 3-9 cm). None of the 82 low anterior resections was covered by a defunctioning stoma. Clinical anastomotic leakage occurred in 4 patients (4.9%) and 4 other patients presented radiologically detected leakage (4.9%). No death occurred in the 8 patients that presented anastomotic dehiscence. Non-specific complications were detected in 11 (13.4%) of 82 patients. In conclusion, the low leakage rate of the anastomoses in our patients allows us to recommend low anterior resection without defunctioning stoma.
authors.affiliation: Fourth Department of Surgery, Aristotle University, Antheon 1, Panorama, GR-55236 Thessaloniki, Greece. ik@hol.gr
authors.forename: I
authors.initials: I
authors.lastname: Kanellos
authors.forename: E
authors.initials: E
authors.lastname: Zacharakis
authors.forename: E
authors.initials: E
authors.lastname: Christoforidis
authors.forename: H
authors.initials: H
authors.lastname: Demetriades
authors.forename: D
authors.initials: D
authors.lastname: Betsis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects*; D002277:Carcinoma / Q000503:physiopathology / Q000601:surgery*; D003125:Colostomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D012004:Rectal Neoplasms / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013529:Surgical Wound Dehiscence / Q000209:etiology* / Q000503:physiopathology; D017211:Treatment Failure