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Benign GI diease,Surgical technique
Double-layered hand-sewn anastomosis: a valuable resource for the colorectal surgeon
Cristopher Varela, Manar Nassr, Azharuddin Razak, Nam Kyu Kim
Ann Coloproctol. 2022;38(3):271-275.   Published online March 17, 2022
DOI: https://doi.org/10.3393/ac.2021.00990.0141
  • 16,102 View
  • 282 Download
  • 4 Web of Science
  • 5 Citations
AbstractAbstract PDFSupplementary Material
Hand-sewn anastomosis is an essential and fundamental skill for surgeons dealing with any gastrointestinal anastomosis. Despite the advances in minimally invasive surgery and stapling devices, there are still complex surgical circumstances when the surgeon’s surgical know-how are necessary. Therefore, a safe hand-sewn technique for bowel anastomosis is required to establish a tension-free, well-perfused, and sealed anastomosis that allows gastrointestinal continuity with no unexpected complications. We describe a step-by-step procedure for hand-sewn double-layered anastomosis that reflects these principles and is practical for small and large bowel anastomosis.

Citations

Citations to this article as recorded by  
  • How to Do a Continuous Inverting Bowel Anastomosis Employing Counter‐Traction
    Sunil Siri Pathamanathan, Warunika Jayasena, Steven Due, Harjit Singh
    ANZ Journal of Surgery.2026;[Epub]     CrossRef
  • A Prospective Comparative Study Between Stapler and Handsewn Gastrointestinal Anastomosis
    Gollapudi Sai Viswanth, Dayanand Biradar, Mallikarjun B Patil, Vikram Sindagikar, Anand Suntan, Veena Korishetty
    Cureus.2026;[Epub]     CrossRef
  • Grampeadores mecânicos versus sutura manual em Anastomoses intestinais: uma revisão sistemática
    Letícia Meneses Teixeira, Yuri Fleury de Melo Prudente Guimarães, Leonardo de Oliveira Leite Coelho, Leo Ferreira Mattos De Miranda
    RCMOS - Revista Científica Multidisciplinar O Saber.2025;[Epub]     CrossRef
  • Fluorescence-guided colorectal surgery: applications, clinical results, and protocols
    Jin-Min Jung, In Ja Park, Eun Jung Park, Gyung Mo Son
    Annals of Surgical Treatment and Research.2023; 105(5): 252.     CrossRef
  • Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
    Hyun Gu Lee
    The Ewha Medical Journal.2023;[Epub]     CrossRef
Review
Malignant disease, Rectal cancer,Prognosis and adjuvant therapy,Colorectal cancer
Surgical Treatment of Low-Lying Rectal Cancer: Updates
Cristopher Varela, Nam Kyu Kim
Ann Coloproctol. 2021;37(6):395-424.   Published online December 22, 2021
DOI: https://doi.org/10.3393/ac.2021.00927.0132
  • 16,009 View
  • 434 Download
  • 54 Web of Science
  • 59 Citations
AbstractAbstract PDF
Despite innovative advancements, distally located rectal cancer remains a critical disease of challenging management. The crucial location of the tumor predisposes it to a circumferential resection margin (CRM) that tends to involve the anal sphincter complex and surrounding organs, with a high incidence of delayed anastomotic complications and the risk of the pelvic sidewall or rarely inguinal lymph node metastases. In this regard, colorectal surgeons should be aware of other issues beyond total mesorectal excision (TME) performance. For decades, the concept of extralevator abdominoperineal resection to avoid compromised CRM has been introduced. However, the complexity of deep pelvic dissection with poor visualization in low-lying rectal cancer has led to transanal TME. In contrast, neoadjuvant chemoradiotherapy (NCRT) has allowed for the execution of more sphincter-saving procedures without oncologic compromise. Significant tumor regression after NCRT and complete pathologic response also permit applying the watch-and-wait protocol in some cases, now with more solid evidence. This review article will introduce the current surgical treatment options, their indication and technical details, and recent oncologic and functional outcomes. Lastly, the novel characteristics of distal rectal cancer, such as pelvic sidewall and inguinal lymph node metastases, will be discussed along with its tailored and individualized treatment approach.

Citations

Citations to this article as recorded by  
  • Advantages of skeletonizing the left colic artery in low anterior resection cases related to vascularity with ICG: A systematic review
    Sarim Rashid, Muhammad Zeeshan, Almaz Rehman, Muhammad Adeel, Abida Parveen
    Medicine.2026; 105(5): e44491.     CrossRef
  • Preoperative Magnetic Resonance Imaging Results Are Concordant with Pathology Staging in Rectal Cancer
    Dursun Burak Ozdemir, Serdar Senol, Mirsad Yalcinkaya
    Medicina.2026; 62(2): 328.     CrossRef
  • Oncologic impact of technical difficulties during the early experience with laparoscopic surgery for colorectal cancer: long-term follow-up results of a prospective cohort study
    Hong-min Ahn, Tae Gyun Lee, Hye-Rim Shin, Jeehye Lee, In Jun Yang, Jung Wook Suh, Heung-Kwon Oh, Duck-Woo Kim, Sung-Bum Kang
    Current Problems in Surgery.2025; 63: 101694.     CrossRef
  • Comparative efficacy analysis of laparoscopic-assisted transanal total mesorectal excision vs laparoscopic transanal mesorectal excision for low-lying rectal cancer
    Feng Lu, Shu-Guang Tan, Juan Zuo, Hai-Hua Jiang, Jian-Hua Wang, Yu-Ping Jiang
    World Journal of Gastrointestinal Surgery.2025;[Epub]     CrossRef
  • Risk factors influencing sphincter preservation in laparoscopic radical rectal cancer surgery
    Jia-Rui Liu, Jin Zhang, Xiang-Long Duan
    World Journal of Gastrointestinal Surgery.2025;[Epub]     CrossRef
  • Clinical using of innovative biodegradable stent with extension sleeve in Ta_tme for low rectal cancer with high risk of anastomotic leakage
    Rongrong Hao, Wensheng Wang, Yuanhang Ma, Jianghong Chen, Yunbo Li, Yang Yang, Dan Ma, Zhicao Zhang
    Scientific Reports.2025;[Epub]     CrossRef
  • Robotic-assisted colorectal surgery in colorectal cancer management: a narrative review of clinical efficacy and multidisciplinary integration
    Engeng Chen, Li Chen, Wei Zhang
    Frontiers in Oncology.2025;[Epub]     CrossRef
  • Radiomic Features of Mesorectal Fat as Indicators of Response in Rectal Cancer Patients Undergoing Neoadjuvant Therapy
    Francesca Treballi, Ginevra Danti, Sofia Boccioli, Sebastiano Paolucci, Simone Busoni, Linda Calistri, Vittorio Miele
    Tomography.2025; 11(4): 44.     CrossRef
  • Unlocking the in vivo therapeutic potential of radiation-activated photodynamic therapy for locally advanced rectal cancer with lymph node involvement
    Rui Sang, Sheri Nixdorf, Tzongtyng Hung, Carl Power, Fei Deng, Thuy Anh Bui, Alexander Engel, Ewa M. Goldys, Wei Deng
    eBioMedicine.2025; 116: 105724.     CrossRef
  • MRI Monitoring of Locally Advanced Rectal Cancer in Watch and Wait Patients
    Jian Zhao, Kanghua Huang, Akao Zhu, Jinghan Zhu, Yimin Fang, Xiaofeng Zhou, Hao Jiang, Li Shen, Haiyan Chen
    Clinical Colorectal Cancer.2025; 24(3): 378.     CrossRef
  • Real‐World Long‐Term Outcomes of Operated and Non‐Operated Rectal Cancer in the Elderly: A 14‐Year Retrospective Multicentre Study
    Harun Demir, Gül Kanyılmaz, İbrahim Babalıoğlu, Bedriye Doğan, Meryem Aktan, Berrin Benli Yavuz, Ayşe Sümeyye Safi
    Journal of Medical Imaging and Radiation Oncology.2025; 69(5): 586.     CrossRef
  • Sagittal FOCUS-MUSE Diffusion-weighted Imaging MRI Improves the Accuracy of Rectal Cancer Location: A Prospective Observational Study
    Jingjing Liu, Wei Sun, Shujie Zhang, Gengyun Miao, Lamei Deng, Mengsu Zeng, Liheng Liu
    Academic Radiology.2025; 32(10): 5887.     CrossRef
  • Personalized Treatment Modalities for Rectal Cancer: Advances in Neoadjuvant Treatment
    Nussara Pakvisal, Leontios Pappas, Bennett A. Caughey, Rocco Ricciardi, Aparna Parikh
    Journal of Clinical Medicine.2025; 14(13): 4411.     CrossRef
  • Sphincter-preserving surgical techniques in low rectal cancer management: A systematic review of contemporary evidence
    Song Wang, A-Jian Li, Hui-Hong Jiang, Yin Lin, Hai-Bo Ding
    World Journal of Gastrointestinal Surgery.2025;[Epub]     CrossRef
  • Incidence, Risk Factors, and Prediction Model of Parastomal Hernia After Abdominoperineal Resection for Rectal Cancer
    Jiyun Li, Jichuan Quan, Zixing Zhu, Dedi Jiang, Zhixun Zhao, Mingguang Zhang, Jianjun Bi, Qiang Feng, Zheng Wang, Haitao Zhou, Wei Pei, Qian Liu, Zhaoxu Zheng, Minjie Wang, Jianwei Liang
    World Journal of Surgery.2025; 49(10): 2680.     CrossRef
  • A Predictive Model for Anastomotic Complications After Sphincter-Preserving Surgery for Rectal Cancer: Integrating Clinical and Anatomical Risk Factors
    Chih-Yu Kuo, Chen-Yin Lee, Ching-Huei Kung, James Chi-Yong Ngu, Li-Jen Kuo
    Diseases of the Colon & Rectum.2025; 68(11): 1296.     CrossRef
  • Ileal J-Pouch interposition as a salvage technique for failed coloanal anastomosis: a case report
    Saeed Derakhshani, Milad Karimian Ghadim, Sara Ashtari
    BMC Surgery.2025;[Epub]     CrossRef
  • Effects of clinical information on the treatment decisions for good responders to neoadjuvant chemoradiotherapy among rectal cancer patients
    Eon Bin Kim, In Ja Park, Hwa Jung Kim, Jong Keon Jang, Seong Ho Park, Young Il Kim, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu
    Annals of Coloproctology.2025; 41(5): 473.     CrossRef
  • POSTOPERASİON YOĞUN BAĞIRSAQ FİSTULU OLAN PASİYENTLƏRDƏ ŞÜA DİAQNOSTİKASI METODLARININ EFFEKTİVLİYİNİN MÜQAYİSƏLİ TƏHLİLİ
    A.N. Mustafayev, Z.Ə. Hacıyev
    Azerbaijan Medical Journal.2025; (3): 44.     CrossRef
  • Elderly Rectal Cancer: An Updated Review
    Chih-Kai Huang, Chi-Hsiu Shih, Yung-Shuo Kao
    Current Oncology Reports.2024; 26(2): 181.     CrossRef
  • Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
    Chungyeop Lee, In Ja Park
    The World Journal of Men's Health.2024; 42(2): 304.     CrossRef
  • Robotic-Assisted versus Laparoscopic Surgery for Rectal Cancer: An Analysis of Clinical and Financial Outcomes from a Tertiary Referral Center
    Jasper Max Gebhardt, Neno Werner, Andrea Stroux, Frank Förster, Ioannis Pozios, Claudia Seifarth, Christian Schineis, Benjamin Weixler, Katharina Beyer, Johannes Christian Lauscher
    Journal of Clinical Medicine.2024; 13(6): 1795.     CrossRef
  • Study of surgical feasibility and outcome of laparoscopic surgery in malignant rectal tumors
    Islam Abdelkhalek, Galal AbuElnagah, Tarek Elfayoumi, Ahmed shoukry Hafez, Mohamed Asal
    Alexandria Journal of Medicine.2024; 60(1): 113.     CrossRef
  • Postoperative Imaging Findings of Colorectal Surgery: A Pictorial Essay
    Inkeon Yeo, Myung-Won Yoo, Seong Jin Park, Sung Kyoung Moon
    Journal of the Korean Society of Radiology.2024; 85(4): 727.     CrossRef
  • Complications Rate and Related Factors After Laparoscopic Sphincter-Preserving Total Mesorectal Excision for Low Rectal Cancer: A Single-Center Study in Vietnam
    Ly Huu Phu, Ho Tat Bang, Ung Van Viet, Hoang Danh Tan, Nguyen Trung Tin
    Cureus.2024;[Epub]     CrossRef
  • Tailoring rectal cancer surgery: Surgical approaches and anatomical insights during deep pelvic dissection for optimal outcomes in low‐lying rectal cancer
    Youn Young Park, Nam Kyu Kim
    Annals of Gastroenterological Surgery.2024; 8(5): 761.     CrossRef
  • Personalized Decisional Algorithms for Soft Tissue Defect Reconstruction after Abdominoperineal Resection for Low-Lying Rectal Cancers
    Dan Cristian Moraru, Mihaela Pertea, Stefana Luca, Valentin Bejan, Andrian Panuta, Raluca Tatar, Dan Mircea Enescu, Dragos Viorel Scripcariu, Viorel Scripcariu
    Current Oncology.2024; 31(6): 3253.     CrossRef
  • Comparative analysis of organ preservation attempt and radical surgery in clinical T2N0 mid to low rectal cancer
    Hyeung-min Park, Jaram Lee, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
    International Journal of Colorectal Disease.2024;[Epub]     CrossRef
  • Essential knowledge and technical tips for total mesorectal excision and related procedures for rectal cancer
    Min Soo Cho, Hyeon Woo Bae, Nam Kyu Kim
    Annals of Coloproctology.2024; 40(4): 384.     CrossRef
  • The role of robotic-assisted surgery in the management of rectal cancer: a systematic review and meta-analysis
    Chenxiong Zhang, Hao Tan, Han Xu, Jiaming Ding
    International Journal of Surgery.2024; 110(10): 6282.     CrossRef
  • Endoscopic submucosal dissection for superficial ultra-low rectal tumors: outcomes and predictive factors for procedure difficulty
    Yinxin Wu
    American Journal of Cancer Research.2024; 14(12): 5784.     CrossRef
  • Pathologic Implications of Magnetic Resonance Imaging-detected Extramural Venous Invasion of Rectal Cancer
    Hyun Gu Lee, Chan Wook Kim, Jong Keon Jang, Seong Ho Park, Young Il Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
    Clinical Colorectal Cancer.2023; 22(1): 129.     CrossRef
  • Customized Denonvilliers’ Fascia Excision: An Advanced Total Mesorectal Excision Technique for Anteriorly Located Rectal Cancer
    Sung Uk Bae, Cristopher Varela, Manar Nassr, Nam Kyu Kim
    Diseases of the Colon & Rectum.2023; 66(6): e304.     CrossRef
  • Organ preservation for early rectal cancer using preoperative chemoradiotherapy
    Gyung Mo Son
    Annals of Coloproctology.2023; 39(3): 191.     CrossRef
  • The Safe Values of Quantitative Perfusion Parameters of ICG Angiography Based on Tissue Oxygenation of Hyperspectral Imaging for Laparoscopic Colorectal Surgery: A Prospective Observational Study
    Gyung Son, Armaan Nazir, Mi Yun, In Lee, Sun Im, Jae Kwak, Sang-Ho Park, Kwang-Ryul Baek, Ines Gockel
    Biomedicines.2023; 11(7): 2029.     CrossRef
  • International Society of University Colon and Rectal Surgeons survey of surgeons’ preference on rectal cancer treatment
    Audrius Dulskas, Philip F. Caushaj, Domas Grigoravicius, Liu Zheng, Richard Fortunato, Joseph W. Nunoo-Mensah, Narimantas E. Samalavicius
    Annals of Coloproctology.2023; 39(4): 307.     CrossRef
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    Cancer Research and Treatment.2023; 55(4): 1261.     CrossRef
  • Do Laparoscopic Approaches Ensure Oncological Safety and Prognosis for Serosa-Exposed Colon Cancer? A Comparative Study against the Open Approach
    Ji-Hyun Seo, In-Ja Park
    Cancers.2023; 15(21): 5211.     CrossRef
  • Low anterior resection syndrome: is it predictable?
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    Annals of Coloproctology.2023; 39(5): 373.     CrossRef
  • Beyond the Horizon: Unveiling the Frontiers of Rectal Cancer Research and Treatment
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    Cureus.2023;[Epub]     CrossRef
  • Optimal surgical techniques for curative resection of the rectal cancer
    Hyeon Woo Bae, Nam Kyu Kim
    Formosan Journal of Surgery.2023; 56(6): 171.     CrossRef
  • Unveiling the profound advantages of total neoadjuvant therapy in rectal cancer: a trailblazing exploration
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    Annals of Surgical Treatment and Research.2023; 105(6): 341.     CrossRef
  • Advances in the Treatment of Colorectal Cancer with Peritoneal Metastases: A Focus on Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
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Letter to the Editor
Benign proctology
Comments on: factors predicting the presence of concomitant enterocele and rectocele in female patients with external rectal prolapse
Ingrid Melo-Amaral, Adrian Teran-Cardoza, Cristopher Varela
Ann Coloproctol. 2022;38(1):93-94.   Published online November 29, 2021
DOI: https://doi.org/10.3393/ac.2021.00892.0127
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