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Short term oncological results of the tri-stapling technique for low anterior resections

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Introduction: Rectal cancer is one of the most common human malignant diseases and the second most common cancer in the large intestine. The standard of care treatment for rectal cancer is currently curative surgical resection. Improvements in local control and survival have been observed with the implementation of total mesorectal excision (TME) and neoadjuvant chemoradiotherapy. This study compares the short term oncological and postoperative results of two techniques for the resection of the specimen during low anterior resection for rectal cancer in an emergency abdominal surgery department. Materials and method: We retrospectively analyzed data from 47 patients operated for rectal cancer in our department from January 2013 to May 2015. All patients were diagnosed with upper or mid rectal cancer and LAR was performed in all cases. In 23 cases the technique chosen for resection of the specimen was the “tri-staple” technique which uses a second stapler instead of the more frequently used curved clamp.

Results: No significant differences were observed regarding operating time, quality of resection, return to bowel function and postoperative complications in a relatively evenly distributed heterogeneous population with rectal adenocarcinoma. Discussion: Different treatment options have been proposed for patients with rectal cancer. Surgery is the mainstay of treatment for patients with resectable tumors. As newer technologies develop continuously and the excisional options expand, open low anterior resection is still standard of care in many centers.

Conclusions: The “tri-staple” technique is safe and feasible but offers few advantages that cannot be achieved by careful and meticulous surgical technique using the more traditional twostaple approach.

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