title: The 'modified triple staple' technique: a variant stapling technique for anastomosis after low anterior resection.
abstract: BACKGROUND
  Stapled techniques of coloanal anastomosis in anterior resection have gained widespread acceptance over hand anastomosis. We believe a modification of the 'triple staple technique' has ergonomic advantages over existing stapling methods and present our technique and experience here.
  
  
  METHODS
  Fifty consecutive patients underwent anterior resection with a concomitant defunctioning ileostomy in 44 (86%) patients. A modified triple staple technique of side to end coloanal anastomosis was performed without the need of a purse string suture on the proximal and the distal segments.
  
  
  RESULTS
  There were no major intra-operative complications. 2/50 (4%) clinical leaks and 2/37 (5.4%) radiological leaks were noted. A combined leak rate of 4/50 (8%) was reported. The incidence of anastomotic stricture encountered was 1/50 (2%).
  
  
  CONCLUSIONS
  The modified triple staple technique for side to end anastomosis in anterior resection has ergonomic advantages and comparable safety to the existing techniques of stapling coloanal anastomosis. We believe this technique can be widely adopted as an added alternative to the current techniques of stapled anastomosis after anterior resection.
authors.affiliation: Colorectal Surgical Unit, Scunthorpe General Hospital, Scunthorpe, UK.
authors.forename: N S
authors.initials: NS
authors.lastname: Balaji
authors.forename: C P
authors.initials: CP
authors.lastname: Macklin
authors.forename: S
authors.initials: S
authors.lastname: Fawole
authors.forename: A S
authors.initials: AS
authors.lastname: Aster
authors.forename: V S R
authors.initials: VS
authors.lastname: Rao
authors.forename: P J
authors.initials: PJ
authors.lastname: Moore
authors.forename: S M
authors.initials: SM
authors.lastname: Ahmad
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D003082:Colectomy / Q000379:methods; D003106:Colon / Q000601:surgery*; D003108:Colonic Diseases / Q000601:surgery*; D006801:Humans; D012007:Rectum / Q000601:surgery*; D013536:Suture Techniques / Q000295:instrumentation*; D016896:Treatment Outcome