Effect of different reinforcement methods on anastomotic leakage prevention after laparoscopic double anastomosis

J Surg Oncol. 2021 May:123 Suppl 1:S81-S87. doi: 10.1002/jso.26333. Epub 2021 Mar 19.

Abstract

Background and objectives: To investigate the effects of different suture reinforcement methods for anastomotic leakage and other postoperative complications after the use of a laparoscopic double stapling technique (DST).

Methods: We collected the data of 124 patients who underwent laparoscopic radical resection of colorectal cancer from July 2017 to September 2018 at our institution. Patients were divided into three groups according to the suture reinforcement methods: intermittent, continuous suture reinforcement, and non-reinforcement (n = 41, 41, and 42, respectively). One-way analysis of variance, χ2 , Fisher's exact, and nonparametric tests were used for statistical analysis.

Results: Among the 124 patients, there were no statistically significant differences in operation times, intraoperative blood loss, postoperative hospital stays and recovery of bowel movement. Nine patients were diagnosed with anastomotic leakage (AL). The incidences of serious AL in the intermittent and continuous suture reinforcement groups were lower than that in the control group, with lower reoperation rate, shorter average lengths of stay and lower treatment costs of two experimental groups.

Conclusion: Intermittent and continuous sutures after laparoscopic DST is effective, safe, and feasible on anastomotic leakage prevention. These procedures could be popularized in rectal surgery on patients with high risk of AL.

Keywords: double stapling technique; laparoscopic surgery; rectal cancer; reinforcement suture.

MeSH terms

  • Anastomosis, Surgical / adverse effects
  • Anastomosis, Surgical / methods*
  • Anastomotic Leak / prevention & control*
  • Blood Loss, Surgical
  • Colorectal Neoplasms / surgery*
  • Female
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Retrospective Studies