Laparoscopic mechanical colorectal anastomosis: technical aspects of formation and their role in the prevention of insolvency

Introduction. Colon cancer occupies one of the leading positions in the structure of oncological morbidity. One of the most severe and sometimes life-threatening complications of sphincter-sparing operations is the failure of the colorectal anastomosis, which occurs in 13 to 30 % of cases, and the associated postoperative mortality reaches 6.0-39.3 %.

The aim of the study. Improved results of surgical treatment of rectal cancer due to reduced number of cases of colorectal anastamosis failure by using in clinical practice modified method of formation of laparoscopic intracorporeal mechanical colorectal anastomosis.

Material and methods. The study included 80 patients: group I - 46 (57.5 %) patients who underwent laparoscopic anterior resection of the rectum in the conventional way; Group II included 34 patients (42.5 %) who were operated on according to the developed technique for the formation of intracorporeal colorectal anastomosis.

Results. In group I, in 4 cases, radiological failure of the anastomosis was established in the presence of a preventive stoma, in 3 patients a clinically significant failure was noted, requiring repeated intervention. Localization of suture failure in 85.7 % of cases developed in the blind pocket (“dog ears”). In group II, 2 patients with incompetence were identified, who were treated conservatively.

Conclusions. The advantage of the original method of applying colorectal anastomosis is the ability to adapt the walls of the sutured sections of the intestine even with repeated stitching of the intestinal stump with a linear apparatus.

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