Low anterior resection with transanal transection and single-stapled anastomosis: technical aspects and initial results

Int J Colorectal Dis. 2024 Jun 5;39(1):85. doi: 10.1007/s00384-024-04646-3.

Abstract

Background: Rectal cancer (RC) is a surgical challenge due to its technical complexity. The double-stapled (DS) technique, a standard for colorectal anastomosis, has been associated with notable drawbacks, including a high incidence of anastomotic leak (AL). Low anterior resection with transanal transection and single-stapled (TTSS) anastomosis has emerged to mitigate those drawbacks.

Methods: Observational study in which it described the technical aspects and results of the initial group of patients with medium-low RC undergoing elective laparoscopic total mesorectal excision (TME) and TTSS.

Results: Twenty-two patients were included in the series. Favourable postoperative outcomes with a median length of stay of 5 days and an AL incidence of 9.1%. Importantly, all patients achieved complete mesorectal excision with tumour-free margins, and no mortalities were reported.

Conclusion: TTSS emerges as a promising alternative for patients with middle and lower rectal tumours, offering potential benefits in terms of morbidity reduction and oncological integrity compared with other techniques.

Keywords: Anastomotic leak; Rectal cancer surgery; Single-stapled; TTSS.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anal Canal* / surgery
  • Anastomosis, Surgical* / methods
  • Anastomotic Leak / etiology
  • Anastomotic Leak / prevention & control
  • Female
  • Humans
  • Laparoscopy / methods
  • Male
  • Middle Aged
  • Rectal Neoplasms* / surgery
  • Rectum / surgery
  • Surgical Stapling* / methods
  • Treatment Outcome