Triangulating stapling technique for reconstruction after colectomy.
OBJECTIVE
To retrospectively compare the triangulating stapling technique for colocolonic anastomosis with hand-sewn anastomosis and functional end-to-end anastomosis.


METHODS
Data from 646 patients who underwent colectomy for cancer from 1993 to 2004 were extracted by chart review. Patients were divided into three groups based on the type of anastomosis: handsewn (n=233), functional end-to-end (n=71), and the triangulating stapling method (n=346). Demographic data and clinical characteristics of the three groups were similar.


RESULTS
Anastomotic leakage was significantly more common in the hand-sewn group than the triangular stapling group (hand-sewn; 3.0%, functional end-to-end; 2.8%, triangulating, 0.6%) (P < 0.05). No patient developed bleeding or stenosis at the anastomosis, and the incidence of wound infection was equivalent among the three groups. One death due to anastomotic failure occurred in each of the functional end-to-end and triangulating stapling groups. The cost of triangulating stapling was approximately Yen 36,000 lower than the cost of the functional end-to-end anastomosis.


CONCLUSIONS
The triangulating stapling technique is an attractive alternative to other methods for creating a colocolonic anastomosis.
Fukunaga
Y
Y
Department of Gastroenterological Surgery, Osaka City General Hospital, Japan. YosukeF@aol.com
Higashino
M
M
Tanimura
S
S
Osugi
Harushi
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000191:economics / Q000379:methods*; D003082:Colectomy / Q000191:economics / Q000379:methods*; D003110:Colonic Neoplasms / Q000191:economics / Q000473:pathology / Q000601:surgery*; D003125:Colostomy / Q000191:economics / Q000379:methods; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000191:economics / Q000379:methods; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D013528:Surgical Staplers / Q000191:economics; D013536:Suture Techniques / Q000191:economics