title: [Double stapler technique in colorectal surgery].
abstract: BACKGROUND
  Colorectal surgery has evolved significantly during the last 35 years. The circular stapler and the double stapler techniques have favored the development of very low rectal anastomoses with reduction in anastomotic leakage. The objective of this study is to evaluate the functional results and complication rate of this surgical technique in the Department of Colorectal Surgery at the Hospital de Especialidades, Centro Medico Nacional Siglo XXI and at the Hospital Angeles del Pedregal, both located in Mexico City.
  
  
  METHODS
  Clinical records of patients who underwent surgery from May 1995 to December 2005 using the double stapler technique and performed by the authors were reviewed.
  
  
  RESULTS
  The study included 142 patients, 55 of whom had rectosigmoid cancer resections. Average age was 60.1 years (male predominance 52.05%). The circular stapler most frequently used was CDH 33 (Johnson & Johnson). Average distance between the anal margin and the anastomoses for extended low anastomoses was 3.21 cm (low 7.8 cm and high 13.7 cm), and the rate of anastomoses leak was 3.52%.
  
  
  CONCLUSIONS
  Double stapler technique used to treat rectosigmoid pathology is safe, secure and assures intestinal continuity in low anterior as well as extended low anterior resections with primary anastomoses. In those patients with associated risk factors and low extended low anterior resection with primary anastomoses, we recommend performing a protective stoma (ileostomy).
authors.affiliation: Departamento de Cirugía de Colon y Recto, Hospital de Especialidades, Centro Médico Nacional Siglo XXI and Hospital Angeles del Pedregal, Mexico, D.F., Mexico. dredvilla@prodigy.net.mx
authors.forename: Eduardo
authors.initials: E
authors.lastname: Villanueva-Sáenz
authors.forename: Ernesto
authors.initials: E
authors.lastname: Sierra-Montenegro
authors.forename: Moisés
authors.initials: M
authors.lastname: Rojas-Illanes
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Peña-Ruiz Esparza
authors.forename: Paulino
authors.initials: P
authors.lastname: Martínez Hernández-Magro
authors.forename: Luis Enrique
authors.initials: LE
authors.lastname: Bolaños-Badillo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods; D003093:Colitis, Ulcerative / Q000601:surgery; D003108:Colonic Diseases / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000601:surgery; D043963:Diverticulosis, Colonic / Q000601:surgery; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012002:Rectal Diseases / Q000601:surgery*; D012189:Retrospective Studies; D013528:Surgical Staplers; D017792:Surgical Stapling / Q000379:methods*; D016896:Treatment Outcome