Autonomic Nerve-Preserving Total Mesorectal Excision in the Laparoscopic Era

Diseases of the Colon &Amp; Rectum

et al. 2009

130

Section: Discussionmentioning

confidence: 99%

Single-Stage Totally Robotic Dissection for Rectal Cancer Surgery: Technique and Short-Term Outcome in 50 Consecutive Patients

Choi

Kim

Diseases of the Colon &Amp; Rectum

et al. 2009

130

“…All patients received standard bowel preparation and antibiotic prophylaxis. The laparoscopic surgical technique was standardized, as described previously [27,28]. High ligation of IMA was routinely performed, although low ligation of IMA (i.e., preservation of left colic artery) was performed in some cases depending on the patient's condition.…”

Section: Surgical Methodsmentioning

confidence: 99%

Evaluation of intestinal perfusion by ICG fluorescence imaging in laparoscopic colorectal surgery with DST anastomosis

et al. 2016

Self Cite

“…The surgical procedure was standardized, as described previously 17. We routinely performed high ligation of the inferior mesenteric artery.…”

Section: Methodsmentioning

confidence: 99%

The Relationship Between the Number of Intersections of Staple Lines and Anastomotic Leakage After the Use of a Double Stapling Technique in Laparoscopic Colorectal Surgery

Ahn²,

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

2017

Purpose:Laparoscopic intracorporeal colorectal anastomosis with double stapling technique is difficult because of unsuitable cutting angle in narrow pelvic cavity. For reasons of tilted and long linear staple line of rectal stump, circular anastomotic plane can make multiple intersections. The present study was designed to assess whether multiple intersections after double stapling technique is the risk factor of anastomotic complication in laparoscopic colorectal surgery.Materials and Methods:In total, 128 consecutive left colon and rectal cancer patients who underwent laparoscopic rectal resection with double stapling technique were enrolled in this study. In all cases, operator tried to reduce intersections by inversion and invagination techniques. They were subdivided into 3 groups: 58 patients with no intersection of staple lines (group A), 62 patients with 1 point of intersection (group B) and 8 patients with 2 points of intersection (group C). Intraoperative air leakage, incomplete cut ring, postoperative bleeding, anastomotic stenosis, and leakage were compared between the 3 groups.Results:Clinical anastomotic leakage was identified in 1 (group C) of 128 patients (0.7%). Overall anastomotic leakage rate was 0% (0/58) in group A, 0% (0/62) in group B, and 12.5% (1/8) in group C (P=0.001). In univariate analysis, intersections of staple lines were associated with anastomotic complications. There were no statistically significant differences between the 3 groups in multivariate analysis.Conclusions:The number of intersections of staple lines is associated with anastomotic leakage, and the inversion technique is a useful method for avoiding anastomotic leakage. Using an appropriate technique by skilled operator, double stapling technique for laparoscopic anterior resection is safe and feasible.