title: [Stapled vs. hand-sewn colorectal anastomosis in complicated colorectal cancer--a retrospective study].
abstract: Emergens in colorectal pathology are in most cases by complications of cancer. The prognosis for colorectal cancer is poor when this pathology is addressed in emergency situations because, on one hand, of the organ specific structure, blood supply, septic content and, on the other hand, because of the special group of patients with this pathology: aged, immunosuppressed and with various comorbidities. The high rate of postoperative complications of these patients requires a specific management. The development and improvement of medical devices has brought to the surgeons new products among which mechanice devices for anastomoses. In this study we compared two groups of operated patients (with hand sutured and stapled anastomoses) who presented as emergences with complications of colorectal cancer.
  
  
  METHODS
  Retrospective clinical study with a total of 72 patients who underwent a colorectal resection procedure in emergency in our clinic (Emergency Hospital Bucharest) over a period of 2 years (2007-2008).
  
  
  RESULTS
  The 72 patients who required emergency surgery were randomly assigned to 2 categories according to the type of anastomosis: hand sutured (group 1, n = 34) and stapled (group 2, n = 38). Age, sex, comorbidities, and tumor staging were comparable in both groups. The emergency was represented by obstruction (56.94%), hemorrhage (8.33%) and perforation (34.72%). The mortality (10.5% vs. 8.8%) and orbidity rate (20.83% vs. 15.27%) was higher in the stapled anastomosis group. The average duration of the surgical procedure performed in emergency was also quantified and was 118 min. (group 2) vs. 236 min. (group 1) respectively.
  
  
  CONCLUSIONS
  Comparison did not disclose any significant difference in the number of complications in these two groups. Anastomosis is safe in emergency colorectal surgery and the reduction of the operative time may also improve the outcome of these patients.
authors.affiliation: Clinica de Chirurgie, Spitalul Clinic de Urgenţă Bucureşti. drmirceabeuran@yahoo.com
authors.forename: M
authors.initials: M
authors.lastname: Beuran
authors.forename: Al L
authors.initials: AL
authors.lastname: Chiotoroiu
authors.forename: A
authors.initials: A
authors.lastname: Chilie
authors.forename: S
authors.initials: S
authors.lastname: Morteanu
authors.forename: M
authors.initials: M
authors.lastname: Vartic
authors.forename: M
authors.initials: M
authors.lastname: Avram
authors.forename: O
authors.initials: O
authors.lastname: Roşu
authors.forename: I
authors.initials: I
authors.lastname: Lică
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D015179:Colorectal Neoplasms / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction; D007416:Intestinal Perforation; D008297:Male; D008875:Middle Aged; D009339:Needles; D009367:Neoplasm Staging; D019106:Postoperative Hemorrhage; D012189:Retrospective Studies; D012307:Risk Factors; D013528:Surgical Staplers; D013536:Suture Techniques / Q000295:instrumentation*; D016896:Treatment Outcome