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The Impact of Circular Stapler Size on the Risk of Anastomotic Stricture Following Total Mesorectal Excision in Rectal Cancer Patients: A Retrospective Cross-Sectional Study Publisher



Behboudi B1, 2 ; Ahmaditafti SM1, 2 ; Hosseini SA1, 2 ; Tadbirvajargah K1, 2 ; Fazeli MS1, 2 ; Hadizadeh A1, 3 ; Poopak A1, 2 ; Keramati MR1, 2 ; Kazemeini A1 ; Ayati A3 ; Yousefikoma H3
Authors
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Authors Affiliations
  1. 1. Colorectal Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Division of Colorectal surgery, Department of surgery, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Research Center for Advanced Technologies in Cardiovascular Medicine, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran

Source: Health Science Reports Published:2023


Abstract

Introduction: Colorectal cancer (CRC) surgery complications are a major issue affecting morbidity and mortality rates. Anastomotic stricture, which occurs in almost 30% of patients after surgery for rectal cancer, is one of the most serious but underreported side effects. In this study, we tried to assess the effect of stapler size on anastomotic stricture rate. Materials and Methods: At our facility, all patients underwent low anterior resections (LAR) performed using an open laparotomy technique. A contour-curved stapler and an end-to-end anastomosis (EEA) circular stapler were used in the double stapling technique (DST). All patients also underwent a protective loop ileostomy. Patients who developed stricture following leakage were excluded. Results: This study comprised a total of 173 rectal cancer patients. A 29-mm circle stapler was used to anastomose 77 patients (44.5%), while a 31-mm circular stapler was used to anastomose 96 patients (55.5%). Six individuals experienced strictures; two had a 29 mm stamper and four (4.4%) had a 31 mm one. There was no significant difference between the two groups (p:0.575). On aggregate, 8 patients experienced leakage; 3 (3.8%) of these patients received treatment with a 29 mm stapler, whereas 5 (5.2%) received treatment with a 31 mm stapler. Conclusion: this study found no statistically significant difference in the stricture rates and stapler size. The findings of this study provide credibility to the notion that in rectal cancer patients having LAR, strictures can be safely avoided by performing the anastomoses with both staplers. © 2023 The Authors. Health Science Reports published by Wiley Periodicals LLC.