Purpose: Proper transection of the distal rectum is important for reconstruction of bowel continuity in rectal cancer surgery. In this study, we introduced a modified technique for ligation of the distal rectum, and investigated its safety and efficiency to facilitate the rectum transection.
Methods: After complete mobilization and transection of the mesorectum, a cable tie was carefully positioned distal to the tumor, followed by washout and transecting the rectum with a linear stapler. From September 2017 to June 2018, consecutive 67 mid-low rectal cancer patients with laparoscopic anterior resection underwent this technique. Clinical data of these patients, including number of firings, pathological and operative variables, and postoperative outcomes, were compared with those of 132 consecutive patients who underwent traditional surgery from January 2016 to August 2017.
Results: Compared with the traditional method, cable tie ligation significantly reduced the number of firings (1.1 ± 0.32 vs. 1.3 ± 0.52, p < 0.001). A very high ratio of one firing transection of rectum was observed in the cable tie group (94.0% vs. 68.9%, p < 0.001), even in patients with tumor at or below the peritoneal reflection (90.2% vs. 54.4%, p < 0.001), in male patients (95.5% vs. 65.8%, p < 0.001), and in obese patients (93.8% vs. 64.9%, p = 0.005). The mean distal margin was longer in the cable tie group (3.19 ± 1.77 cm vs. 2.54 ± 1.36 cm, p = 0.005), with no positive distal margin observed. The operation time, quality of mesorectum, and morbidity between two groups were comparable. Two leaks (3.0%) in the cable tie group were observed, similar to 3.8% in the control.
Conclusions: Ligation of the rectum with a cable tie reduces the number of cartridges, and increases the rate of one stapler firing for rectal transection, even in those difficult cases like male, overweight, and low rectal cancer patients. It is also useful for occlusion of the rectum before washout. It is safe, feasible, and worthwhile for popularization.
Trial Registration: Registered at ClinicalTrial.gov, number NCT03570684.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00423-020-01863-6 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Compact Arterial Monitoring Device Use in Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): A Simple Validation Study in Swine.
Cureus
October 2024
Department of Anesthesiology, Uniformed Services University of the Health Sciences, Bethesda, USA.
Article Synopsis
- - Hemorrhage is the main cause of preventable death in trauma situations, leading to military and civilian advancements in medical practices, particularly through the use of tourniquets to manage extremity bleeding and save lives.
- - While tourniquets have significantly decreased deaths from bleeding in military settings, noncompressible hemorrhage still poses a major risk, especially before patients receive definitive medical care.
- - The study explores using a small, disposable pressure monitor during resuscitative endovascular balloon occlusion of the aorta (REBOA) to enhance blood pressure monitoring, facilitate better resuscitation practices, and reduce the need for blood products in extreme environments.
Surface Microstructure Study on Corona Discharge-Treated Polyethylene Using Positron Annihilation Spectroscopy.
Molecules
August 2024
Key Laboratory of Nuclear Solid-State Physics Hubei Province, School of Physics and Technology, Wuhan University, Wuhan 430072, China.
The microstructure and chemical properties of the corona discharge process could provide an effective method for predicting the performance of high-voltage cable insulation materials. In this work, the depth profile of the microstructure and chemical characteristics of corona discharge-treated PE were extensively investigated using Doppler broadening of position annihilation spectroscopy accompanied with positron annihilation lifetime spectroscopy, attenuated total reflectance Fourier transform infrared spectra, Raman spectra and contact angle measurement. By increasing corona discharge duration, the oxygen-containing polar groups, including hydroxyl, carbonyl and ester groups, strongly contribute to the deterioration of hydrophobicity and the enhancement of hydrophilicity.
View Article and Find Full Text PDFBiocompatible Cable Ties Are an Alternative to Metal Stabilizers for Bar Securement During Minimally Invasive Pectus Excavatum Repair.
J Laparoendosc Adv Surg Tech A
October 2024
Division of Pediatric Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Bar stabilization during minimally invasive pectus excavatum repair (MIRPE) is critical to avoid dislodgement. Multiple techniques are described including stabilizers, wires, and sutures. This retrospective study compared bar movement and outcomes between existing techniques and ZipFix™, a biocompatible cable tie.
View Article and Find Full Text PDFCable tie technique for securing scleral fixation suture to intraocular lens.
Am J Ophthalmol Case Rep
September 2022
Department of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea.
Purpose: To report a new flanged intrascleral fixation technique for subluxated or dislocated intraocular lens (IOL) with c-loop or double c-loop haptics (cable tie fixation method).
Observations: We introduced a cable tie fixation method using 6-0 polypropylene for subluxated multifocal IOL with C-loop or double C-loop haptics. After passing the 6-0 polypropylene monofilament under the optic-haptic junction, the other end of the strand was taken out of the eye after passing it above the optic-haptic junction.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!