Annals of Coloproctology

Original Article

Minimally invasive surgery

New double-stapling technique without staple-crossing line in laparoscopic low anterior resection: effort to reduce anastomotic leakage: Nam Seok Kim, Ji Hoon Kim, Yoon Suk Lee, In Kyu Lee, Won Kyung Kang; Ann Coloproctol. 2024;40(6):573-579. Published online November 22, 2024; DOI: https://doi.org/10.3393/ac.2022.00409.0058

753 View
67 Download

Graphical Abstract Abstract PDF: Purpose
This study aimed to demonstrate the safety of new double-stapling technique (nDST), without a crossing line and dog ears, by comparing with conventional DST (cDST) in laparoscopic low anterior resection (LAR).
Methods
We retrospectively reviewed 98 consecutive patients who underwent laparoscopic LAR for rectal cancer from January 2018 to December 2020. The inclusion criterion was an anastomosis level below the peritoneal reflection and 4 cm above the anal verge. In the nDST group, the staple line of the linear cutter was sutured using barbed sutures to shorten the staple line before firing the circular stapler. Therefore, there were no crossing lines after firing the circular stapler. A 2:1 propensity score matching was performed between the cDST and nDST groups.
Results
After propensity score matching, 39 patients were in the cDST group and 20 were in the nDST group. There were no significant differences in patient demographics between the 2 groups. There was no difference in the total operation time between the cDST and nDST groups (124.0±26.2 minutes vs. 125.2±20.3 minutes, P=0.853). Morbidity rates were similar between the 2 groups (9 cases [23.1%] vs. 5 cases [25.0%], P=0.855). There was no significant difference in leakage rate (4 cases [10.3%] vs. 1 case [5.0%], P=0.847) and anastomotic bleeding rate (1 case [2.6%] vs. 3 cases [15.0%], P=0.211).
Conclusion
The nDST to eliminate the crossing line and dog ears in laparoscopic LAR is technically feasible and safe. However, more attention should be paid to anastomotic bleeding in such cases.

Review

Colorectal cancer

Outcomes of redo for failed colorectal or coloanal anastomoses: a systematic review and meta-analysis: Ricardo Purchio Galletti, Gabriel Andrade Agareno, Lucas de Abreu Sesconetto, Rafael Benjamim Rosa da Silva, Rafael Vaz Pandini, Lucas Soares Gerbasi, Victor Edmond Seid, Sérgio Eduardo Alonso Araujo, Francisco Tustumi; Ann Coloproctol. 2023;39(5):375-384. Published online December 20, 2022; DOI: https://doi.org/10.3393/ac.2022.00605.0086

3,495 View
136 Download
1 Web of Science
1 Citations

Abstract PDF Supplementary Material

Purpose
This study aimed to review the outcomes of redo procedures for failed colorectal or coloanal anastomoses.
Methods
A systematic review was performed using the PubMed, Embase, Cochrane, and LILACS databases. The inclusion criteria were adult patients undergoing colectomy with primary colorectal or coloanal anastomosis and studies that assessed the postoperative results. The protocol is registered in PROSPERO (No. CRD42021267715).
Results
Eleven articles met the eligibility criteria and were selected. The studied population size ranged from 7 to 78 patients. The overall mortality rate was 0% (95% confidence interval [CI], 0%–0.01%). The postoperative complication rate was 40% (95% CI, 40%–50%). The length of hospital stay was 13.68 days (95% CI, 11.3–16.06 days). After redo surgery, 82% of the patients were free of stoma (95% CI, 75%–90%), and 24% of patients (95% CI, 0%–39%) had fecal incontinence. Neoadjuvant chemoradiotherapy (P=0.002) was associated with a lower probability of being free of stoma in meta-regression.
Conclusion
Redo colorectal and coloanal anastomoses are strategies to restore colonic continuity. The decision to perform a redo operation should be based on a proper evaluation of the morbidity and mortality risks, the probability of remaining free of stoma, the quality of life, and a functional assessment.

Citations

Citations to this article as recorded by

Laparoscopic redo endorectal pull‐through procedure for complex rectovaginal fistula after rectal resection for endometriosis: A Video Vignette
Sergio Eduardo Alonso Araujo, Francisco Tustumi, Ana Sarah Portilho, Lucas de Araujo Horcel, Victor Edmond Seid
Colorectal Disease.2023; 25(11): 2284. CrossRef

Original Article

Intracorporeal versus extracorporeal anastomosis in laparoscopic right hemicolectomy: a retrospective cohort study of anastomotic complications: Jonathan Frigault, Samuel Avoine, Sébastien Drolet, François Letarte, Alexandre Bouchard, Jean-Pierre Gagné, Claude Thibault, Roger C. Grégoire, Naomee Jutras Bouthillette, Maude Gosselin, Philippe Bouchard; Ann Coloproctol. 2023;39(2):147-155. Published online March 29, 2022; DOI: https://doi.org/10.3393/ac.2021.00983.0140

3,662 View
165 Download
7 Web of Science
6 Citations

Abstract PDF

Purpose
Laparoscopic right hemicolectomy (LRH) can be performed with an intracorporeal anastomosis (IA) or extracorporeal anastomosis (EA). It is not clear which technique is best. This study evaluated the impact of each anastomosis technique on perioperative safety and postoperative evolution.
Methods
We performed a retrospective study at a tertiary colorectal surgery center. All patients who had an elective LRH from 2015 to 2019 were analyzed according to the anastomosis technique used.
Results
In total, 285 patients were included in the study. IA was performed in 64 patients (22.5%). Mean operative time was longer in the patients with IA (IA, 160±31 minutes vs. EA, 138±42 minutes; P<0.001). No differences were observed in intraoperative complications, time to first bowel movement, length of stay, reoperation, or rehospitalization. Time to first flatus was longer in the patients with IA (P=0.049). At 30 days after surgery, there were no differences in the frequency of anastomotic leak (IA, 0% vs. EA, 2.3%; P=0.59), bleeding (IA, 3.1% vs. EA, 2.7%; P>0.99), or intraabdominal abscess (IA, 0% vs. EA, 0.5%; P>0.99). During follow-up, we noted more incisional hernias in patients with EA (IA, 1.6% vs. EA, 11.3%; P=0.01) and a trend toward more hernia in patients with EA in multivariate analysis (hazard ratio, 7.13; P=0.06). Anastomosis technique had no influence on recurrence.
Conclusion
For LRH, both IA and EA are safe, with a low incidence of complications when performed by experienced surgeons. IA may be associated with a lower incidence of incisional hernia.

Citations

Citations to this article as recorded by

Comparison of intracorporeal and extracorporeal anastomosis in laparoscopic right colectomy: an updated meta-analysis and trial sequential analysis
Konstantinos Perivoliotis, George Tzovaras, Konstantinos Tepetes, Ioannis Baloyiannis
Updates in Surgery.2024; 76(2): 375. CrossRef
Effectiveness and safety of self-pulling and latter transection reconstruction in totally laparoscopic right hemicolectomy
Fuyu Yang, Fan He, Chenglin Tang, Defei Chen, Junjie Xiong, Yu Zou, Saed Woraikat, Kun Qian, Hui Li
Frontiers in Oncology.2024;[Epub] CrossRef
Single-Center Experiences: A Comparison of Intracorporeal and Extracorporeal Anastomosis Outcomes in Right Hemicolectomy
Audrey Kim, Munyaradzi G Nyandoro, Linda Vu, Ruben Rajan, Abraham Jacob
Cureus.2024;[Epub] CrossRef
Comparing extracorporeal, semi-extracorporeal, and intracorporeal anastomosis in laparoscopic right hemicolectomy: introducing a bridging technique for colorectal surgeons
Hye Jung Cho, Jong Woo Kim, Woo Ram Kim
Annals of Surgical Treatment and Research.2024; 107(1): 42. CrossRef
Effect of Specimen Extraction Site on Postoperative Incisional Hernia after Minimally Invasive Right Colectomy
Josh A Johnson, Andrea Mesiti, Margo Herre, Cyrus Farzaneh, Ying Li, Wini Zambare, Joseph Carmichael, Alessio Pigazzi, Mehraneh D Jafari
Journal of the American College of Surgeons.2024; 239(2): 107. CrossRef
Extracorporeal versus intracorporeal anastomosis for right colon cancer surgery
Seong Kyu Baek
Journal of Minimally Invasive Surgery.2022; 25(3): 91. CrossRef

Technical Notes

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

8,943 View
225 Download
2 Web of Science
2 Citations

Abstract PDF Supplementary 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

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

How to Prevent Anastomotic Leak in Colorectal Surgery? A Systematic Review: Mohamed Ali Chaouch, Tarek Kellil, Camillia Jeddi, Ahmed Saidani, Faouzi Chebbi, Khadija Zouari; Ann Coloproctol. 2020;36(4):213-222. Published online August 31, 2020; DOI: https://doi.org/10.3393/ac.2020.05.14.2

7,308 View
351 Download
21 Web of Science
29 Citations

Abstract PDF

Anastomosis leakage (AL) after colorectal surgery is an embarrassing problem. It is associated with poor consequence. This review aims to summarize published evidence on prevention of AL after colorectal surgery and provide recommendations according to the Oxford Centre for Evidence-Based Medicine. We conducted bibliographic research on January 15, 2020, of PubMed, Cochrane Library, Embase, Scopus, and Google Scholar. We retained meta-analysis, reviews, and randomized clinical trials. We concluded that mechanical bowel preparation did not reduce AL. It seems that oral antibiotic or oral antibiotic with mechanical bowel preparation could reduce the risk of AL. The surgical approach did not affect the AL rate. The low ligation of the inferior mesenteric artery could reduce the AL rate. The mechanical anastomosis is superior to handsewn anastomosis only in case of right colectomies, with similar results in rectal surgery between the 2 anastomosis techniques. In the case of right colectomies, this anastomosis could be performed intracorporeally or extracorporeally with similar outcomes. The air leak test did not reduce AL. There is no interest of external drainage in colonic surgery but drains reduced the rate of AL and rate of reoperation after low anterior resection. The transanal tube reduced the rate of AL.

Citations

Citations to this article as recorded by

Caring for a patient with appendiceal cancer
Richard L. Pullen
Nursing.2025; 55(2): 16. CrossRef
Collagen patch cover facilitates recovery of bowel function after laparoscopic colectomy
Pin-Yang Huang, Meng-Che Tsai, Kee-Thai Kiu, Min-Hsuan Yen, Tung-Cheng Chang
BMC Surgery.2024;[Epub] CrossRef
Impact of the starch-based anti-adhesive agent 4DryField PH on anastomotic healing after rectal surgery
Simon Stoerzer, Markus Winny, Oliver Beetz, Severin Jacobi, Juergen Klempnauer, Daniel Poehnert
International Journal of Surgery Open.2024; 62(1): 6. CrossRef
Bowel preparation for elective colectomy in Crohn's disease: results from a global cohort study using the NSQIP database
Gustavo Yano Callado, Rodrigo Moisés de Almeida Leite, Sergio Eduardo Alonso Araujo, Leandro Cardoso Barchi, Waleed Seddiq, Isabela Passarin Correa, Ulysses Ribeiro Junior, Rocco Ricciardi
Colorectal Disease.2024; 26(4): 709. CrossRef
Does transanal endomicrosurgery affects the results of “salvage mesorectumectomy” for patients with early rectal cancer? Systematic review and meta-analysis
Ph. I. Kirgizov, S. V. Chernyshov, M. A. Nagudov, E. G. Rybakov
Surgery and Oncology.2024; 14(1): 11. CrossRef
Anastomotic leak rate following the implementation of a powered circular stapler in elective colorectal surgeries: a retrospective cohort study
Jessica J. Lie, Nadeesha Samarasinghe, Ahmer A. Karimuddin, Carl J. Brown, P. Terry Phang, Manoj J. Raval, Amandeep Ghuman
Surgical Endoscopy.2024; 38(10): 5541. CrossRef
Morbidity and Mortality after Cytoreductive Surgery and HIPEC in a National Reference Center: A Six-Year Experience under Independent Evaluation
Miguel Enrique Alberto Vilchez, Sebastian Halskov, Axel Winter, Johann Pratschke, Beate Rau, Safak Gül
Journal of Clinical Medicine.2024; 13(17): 5182. CrossRef
Recommendations for the perioperative management of pancreatic and colorectal cancer patients
Tim O. Vilz, Stefan Post, Thomas Langer, Markus Follmann, Monika Nothacker, Maria A. Willis
Deutsches Ärzteblatt international.2024;[Epub] CrossRef
Entre luces y sombras: Factores clave en la fuga anastomótica en cirugía colorrectal, estudio de casos y controles en dos centros de alto volumen en Bogotá
Carolina Riscanevo-Bobadilla, Diego Efrain Valbuena, Andrés Felipe Salcedo-Young, Ronel Eduardo Barbosa, Wilmar Martin, Angela Navas, Daniel Franco
Revista Colombiana de Cirugía.2024; : 99. CrossRef
UNEXPECTED FINDINGS DURING LAPAROTOMY SURGERY AND URGENT SURGICAL INDICATIONS ARE ASSOCIATED WITH POSTOPERATIVE COMPLICATIONS IN PATIENTS WITH CROHN’S DISEASE
Guilherme Zupo TEIXEIRA, Magaly Gemio TEIXEIRA, Marina Carla GIMENEZ, Silvia Caroline Neves RIBEIRO, Nathacia Bernardo CHIMELLO, Vania Aparecida LEANDRO-MERHI
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo).2024;[Epub] CrossRef
Robotic colectomy with CME versus laparoscopic colon resection with or without CME for colon cancer: a systematic review and meta-analysis
H Oweira, C Reissfelder, H Elhadedy, N Rahbari, A Mehrabi, W Fattal, JS Khan, MA Chaouch
The Annals of The Royal College of Surgeons of England.2023; 105(2): 113. CrossRef
The Role of Antibiotic Prophylaxis in Anastomotic Leak Prevention during Elective Colorectal Surgery: Systematic Review and Meta-Analysis of Randomized Controlled Trials
Lidia Castagneto-Gissey, Maria Francesca Russo, James Casella-Mariolo, Angelo Serao, Rosa Marcellinaro, Vito D’Andrea, Massimo Carlini, Giovanni Casella
Antibiotics.2023; 12(2): 397. CrossRef
Refractory Retroperitoneal Abscess Due to Anastomosis Leakage after Transanal Total Mesorectal Excision Combined with Robotic Rectal Resection with Diverting Ileostomy: A Case Report
Yuichiro Nishida, Yuto Hozaka, Shinichiro Mori, Masumi Wada, Kan Tanabe, Yoshiaki Kita, Takaaki Arigami, Akihiro Nakajo, Michiyo Higashi, Hiroshi Kurahara, Takao Ohtsuka
The Japanese Journal of Gastroenterological Surgery.2023; 56(3): 180. CrossRef
Efficacy of transanal drainage tube in preventing anastomotic leakage after surgery for rectal cancer: A meta-analysis
Shiki Fujino, Masayoshi Yasui, Masayuki Ohue, Norikatsu Miyoshi
World Journal of Gastrointestinal Surgery.2023; 15(6): 1202. CrossRef
Surgical aspects of stoma formation in oncology. Literature review
A. S. Gorbunova, D. V. Kuzmichev, Z. Z. Mamedli, A. A. Aniskin, A. V. Polinovsky, D. V. Aleksantsev, A. V. Korshak
Pelvic Surgery and Oncology.2023; 13(2): 54. CrossRef
How to prevent postoperative ileus in colorectal surgery? a systematic review
Mohamed Ali Chaouch, Mohamed Aziz Daghmouri, Abdallah Lahdheri, Mohammad Iqbal Hussain, Salsabil Nasri, Amine Gouader, Faouzi Noomen, Hani Oweira
Annals of Medicine & Surgery.2023; 85(9): 4501. CrossRef
Possible role of features of the intestinal microbiome in patients with colorectal cancer as a cause of anastomotic leak
P. V. Kosareva, R. A. Konev, A. P. Godovalov, L. V. Sivakova, E. I. Samodelkin
Bulletin of Siberian Medicine.2023; 22(3): 120. 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
Pelvic exenteration for gynecologic malignancies: The experience of a tertiary center from Greece
Dimitrios Haidopoulos, Vasilios Pergialiotis, Kyveli Aggelou, Nikolaos Thomakos, Nikolaos Alexakis, Emmanouil Stamatakis, Alexandros Rodolakis
Surgical Oncology.2022; 40: 101702. CrossRef
Diagnostic accuracy of procalcitonin on POD3 for the early diagnosis of anastomotic leakage after colorectal surgery: A meta-analysis and systematic review
Zheng'ao Xu, Rui Zong, Yu Zhang, Jie Chen, Weidong Liu
International Journal of Surgery.2022; 100: 106592. CrossRef
Immediate results of rectal resections for cancer in depending on the restoration of the integrity of the pelvic peritoneal floor: retrospective study
M. S. Lebedko, S. S. Gordeev, S. G. Gaydarov, Z. Z. Mamedli, V. Yu. Kosyrev, A. A. Aniskin, S. O. Kochkina
Pelvic Surgery and Oncology.2022; 11(3-4): 23. CrossRef
Laparoscopic PME with colorectal anstomosis with transanal control – A video vignette
Francesco Crafa, Serafino Vanella, Adele Noviello, Giuseppe Longo, Francesco Longo
Colorectal Disease.2022; 24(7): 887. CrossRef
Risk factors for colorectal anastomotic leakage and preventive measures: a retrospective cohort study
M. S. Lebedko, S. S. Gordeev, E. V. Alieva, M. D. Sivolob, Z. Z. Mamedli, S. G. Gaydarov, V. Yu. Kosyrev
Pelvic Surgery and Oncology.2022; 12(2): 17. CrossRef
Surgical safety in the COVID-19 era: present and future considerations
Young Il Kim, In Ja Park
Annals of Surgical Treatment and Research.2022; 102(6): 295. CrossRef
Colonic splenic flexure resection with an end‐to‐end intracorporeal anastomosis using a circular stapler – A video vignette
Roberto Secchi del Rio, Jose Ignacio Ortiz de Elguea‐Lizarraga, Paulina Muñoz‐Ledo Ceron, Eli Castillo, Victor Gerardo Pena, Diego Marines Copado
Colorectal Disease.2022; 24(11): 1447. CrossRef
Как предотвратить несостоятельность кишечных анастомозов «высокого риска»
Эльчин Агаев, Зульфия Исмайылова, Мушвиг Гасанов
InterConf.2022; (26(129)): 283. CrossRef
Safe Anastomoses without Ostomies in Cytoreductive Surgery with Heated Intraperitoneal Chemotherapy: Technical Considerations and Modifications
Pedro Barrios, Isabel Ramos, Oriol Crusellas, Domenico Sabia, Sergio Mompart, Lana Bijelic
Annals of Surgical Oncology.2021; 28(12): 7784. CrossRef
Early salvage total mesorectal excision (sTME) after organ preservation failure in rectal cancer does not worsen postoperative outcomes compared to primary TME: systematic review and meta-analysis
Mohamed Ali Chaouch, Jim Khan, Talvinder Singh Gill, Arianeb Mehrabi, Christoph Reissfelder, Nuh Rahberi, Hazem Elhadedy, Hani Oweira
International Journal of Colorectal Disease.2021; 36(11): 2375. CrossRef
Regional techniques for pain management following laparoscopic elective colonic resection: A systematic review
Mohamed Aziz Daghmouri, Mohamed Ali Chaouch, Maroua Oueslati, Lotfi Rebai, Hani Oweira
Annals of Medicine and Surgery.2021; 72: 103124. CrossRef

Original Article

Effects of a Glutamine Enema on Anastomotic Healing in an Animal Colon Anastomosis Model: Mani Habibi, Osman Zekai Oner, Mehmet Tahir Oruc, Nurullah Bulbuller, Sebahat Ozdem, Sukru Ozdemir, Arsenal Sezgin Alikanooglu, Rojbin Karakoyun, Ugur Dogan, Ayper Ongen, Umit Koc; Ann Coloproctol. 2015;31(6):213-221. Published online December 31, 2015; DOI: https://doi.org/10.3393/ac.2015.31.6.213

9,615 View
49 Download
4 Web of Science
4 Citations

Abstract PDF

Purpose

Anastomotic leakage in colorectal surgery is a very important issue. Although many studies have shown the positive effects of enteral glutamine (Gln) on anastomotic healing, none has assessed the effects of administering Gln via an enema for anastomotic healing. To fill this study gap, this study investigated the intraluminal effect of administration of Gln enema on the healing of colonic anastomosis in a rat model.

Methods

Thirty Wistar albino rats were divided into three groups containing 10 rats each and were subjected to distal left colon transection and anastomosis. Postoperatively, group I (the control group) was administered no treatment, group II was administered daily placebo enemas containing physiological saline, and group III was administered daily 2% L-Gln enemas. After sacrifice on postoperative day 5, anastomotic healing, burst pressure, tissue hydroxyproline levels, and histological parameters were measured, and group values were compared via statistical analysis.

Results

Group III was found to have the highest mean bursting pressure and tissue hydroxyproline levels and the lowest mean ischemia score. While the values of these parameters were not found to differ significantly among the groups, the lack of significance may have been due to the limited number of subjects examined.

Conclusion

Administration of a Gln enema may have a positive effect on anastomosis in terms of bursting pressure and histopathological parameters. Future research should examine administration of a preoperative Gln enema as a means of decreasing the traumatic effects of the enema and identifying its applicability in surgical practice.

Citations

Citations to this article as recorded by

Effect of Glutamine on Short-term Surgical Outcomes in Rectal Cancer Patients Receiving Neoadjuvant Therapy: A Propensity Score Matching Study
Gang Tang, Feng Pi, Zhengqiang Wei, Xiangshu Li
Nutrition and Cancer.2023; 75(4): 1254. CrossRef
Postoperative parenteral glutamine supplementation improves the short-term outcomes in patients undergoing colorectal cancer surgery: A propensity score matching study
Gang Tang, Feng Pi, Yu-Hao Qiu, Zheng-Qiang Wei
Frontiers in Nutrition.2023;[Epub] CrossRef
The Effects of Hyperthermic Intraperitoneal Chemoperfusion on Colonic Anastomosis: An Experimental Study in a Rat Model
Afag Aghayeva, Cigdem Benlice, Ismail Ahmet Bilgin, Pinar Atukeren, Gulen Dogusoy, Figen Demir, Deniz Atasoy, Bilgi Baca
Tumori Journal.2017; 103(3): 307. CrossRef
Topical Effect of Glutamine for Colorectal Anastomosis
Jong-Woo Kim
Annals of Coloproctology.2015; 31(6): 207. CrossRef

First
Prev
Page of 1
Next
Last

Search