Colorectal stapling anastomosis without transanal procedure for anterior reseciton.

Background/aims: We reported a novel surgical technique, sliding functional end-to-end anastomosis (SFEEA), which abrogates the need for the transanal procedure for colorectal anastomosis. The aim of this study is to evaluate to the usefulness of SFEEA in high anterior resection as compared with double stapling technique (DST).

Methodology: From 2001 to 2005, high anterior resection was performed in 78 consecutive patients with advanced sigmoid colon cancer whose anatomoses with stapler were located under their promontories using SFEEA (n=35) or DST (n=43). We reviewed their medical records for operative duration, intraoperative blood loss, postoperative complications and suture line recurrence retrospectively.

Results: The operation time was a median of 85 (range 60-150) minutes for the SFEEA group compared with 130 (range 60-180) minutes for the DST group (p < 0.001). Intraoperative blood loss was a median of 60 (range 10-520) ml for the SFEEA group compared with 40 (range 10-600) ml for the DST group. In the DST group, two postoperative complications (5%) occurred, leakage and stenosis respectively, compared with no complications in the SFEEA group. Only one suture line recurrence (2%) occurred in the DST group compared with no recurrence in the SFEEA group.

Conclusion: In high anterior resection, SFEEA is easy, safe and useful as compared with DST.