title: Use of the modified double-stapling technique with vertical division of the rectum during a sphincter-preserving operation for the treatment of a rectal tumor.
abstract: OBJECTIVE
  The modified double-stapling technique (DST) with vertical division of the rectum(IO-DST) has been reported as a feasible and safe procedure for performing low anastomosis during rectal cancer surgery. In this procedure, an endostapler was vertically used, instead of using a horizontally orientated linear stapler, when dividing the rectum. A previous study reported that this technique is useful for treating patients with a narrow pelvis and/or performing a very low anastomosis.
  
  
  METHODS
  The use of IO-DST anastomosis during anterior resection(AR) and low anterior resection was performed on 80 cases of rectal cancer between April 1998 and June 2004 at our institution. We reviewed those cases and evaluated the leakage rate.
  
  
  RESULTS
  We found that leakage occurred in six cases (7.5%); however, leakage was not found in cases of AR or cases with a preserved left colic artery (LCA).
  
  
  CONCLUSIONS
  The IO-DST technique is an adequate procedure for performing AR. The preservation of the LCA could be used to prevent leakage.
authors.affiliation: First Department of Surgery, Dokkyo Medical University, School of Medicine, Japan. mtsubaki@yuai-hosp-jp.org
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tsubaki
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ito
authors.forename: Masanori
authors.initials: M
authors.lastname: Fujita
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kato
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000601:surgery*; D000714:Anastomosis, Surgical; D057868:Anastomotic Leak / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D013528:Surgical Staplers; D017792:Surgical Stapling / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome