[Pull-through transection and anastomosis for early lower rectal cancer using double stapling technique].
OBJECTIVE
To introduce the experiences of pull-through transection and double stapling anastomosis for early lower rectal cancer.


METHODS
From May 2001 to March 2008, 25 patients with early stage lower rectal cancer were operated by using pull-through transection and double stapling anastomosis. The average distance between the dentate line and lower margin of the tumor is (3.2 +/- 0.5) cm (2.0 - 4.5 cm). The average tumor diameter is (2.8 +/- 0.8) cm (2.0 - 3.5 cm).


RESULTS
The average distance between the lower margin of the tumor and transection line is (1.5 +/- 0.4) cm (1.1 - 2.2 cm). All the resection margins were negative. Eighteen cases of the anastomosis were above the dentate line, 0.3 - 2.1 cm [(1.7 +/- 0.2) cm] and the other 7 were below, 0.1 - 0.5 cm (average 0.3 cm). Anastomotic leakage occurred in 1 case, and cured with conservative treatment. Local recurrence occurred in 1 case (4.0%), liver metastasis in 3 (12.0%) and lung metastasis in 2(8.0%), respectively. Mild fecal incontinence occurred in 7 cases.


CONCLUSIONS
Compared with trans-abdominal transection of distal rectum in low anterior resection of rectal cancer, pull-through transection and anastomosis provides more precise control of the cutting line and simpler resection.
Fu
Chuan-Gang
CG
Department of Colorectal Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China. fugang416@126.com
Wang
Han-Tao
HT
Wang
Hao
H
D000328:Adult; D001003:Anal Canal / Q000601:surgery; D000714:Anastomosis, Surgical / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012007:Rectum / Q000601:surgery; D012189:Retrospective Studies; D017792:Surgical Stapling / Q000379:methods*