Stapling in surgery of cancer of the rectum. Experience with 100 cases.

Abstract

The authors relate their experience with 100 cases of anterior resections operated using stapling techniques, 43 with double stapling. Fifty three were males and forty seven females, the youngest being 35 year's old and the oldest 87. The tumour was located at the upper third in 54 cases, at the middle third in 41 and at the lower third in five cases. One hundred anterior resections were executed, fifty of the low type. As to the Dukes classification, 15 were A type, 45 type B, 35 type C and 5 type D. There were no operative mortality until the 30th post operative day. As early post-operative complications there were one case of hemorrhage, two pneumopathies, one urinary retention, one cardio-respiratory insufficiency three cases of fistulae and 6 wound infections. In the last 65 cases only one wound infection and two pneumopathies were found. As late complications there were three anastomotic stenosis (all of them satisfactorily solved with dilatation) and six cases with small degree incontinence for gas and faeces recovering spontaneously. The recurrence rate was 14%; in three it has been possible to proceed with its excision by means of abdominoperineal amputation. They conclude stating that mechanical suturing specially is a good alternative to manual suturing in patients with low rectal tumours.