Purpose Stapled anastomotic techniques to the distal rectum have gained widespread acceptance due to their procedural advantages. Various modifications in the stapling techniques have evolved since their inception. The triple-staple technique utilizing stapled closure of both the proximal colon and distal rectal stump provides a rapid and secure colorectal anastomosis. The aims of this study are to determine the safety and efficacy of the triple-staple technique, and to compare the clinical outcomes with a historical control group for which the conventional double-staple technique had been performed. Methods One hundred consecutive patients operated on by a single surgeon were included, 50 patients who underwent double-staple (DSA), then 50 triple-staple anastomoses (TSA). Results The most common indication for surgery in both groups was rectal cancer followed by diverticular disease and distal sigmoid cancer. There was no significant difference in the number of covering loop ileostomy formation in both groups (TSA 56% vs DSA 68%; p=0.621). The mean operating time for the TSA group was significantly shorter compared to the DSA group (243 vs 306 minutes; p=0.001). There was no significant difference in complication rates (TSA 40% vs DSA 50%; p=0.315) and length of hospital stay between the two groups (TSA 11.3 vs DSA 13.0 days, p=0.246). Post-operative complications included anastomotic leak, prolonged ileus, bleeding, wound infection and pelvic collection. Conclusion The triple-staple technique is a safe alternative to the double-staple anastomosis after anterior resection. It also effectively shortens the operating time.
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