A novel colorectal anastomotic method in natural orifice specimen extraction surgery for colorectal cancer

• Published in: Surgery today (Tokyo, Japan) Vol. 52; no. 8; pp. 1202 - 1211
• Main Authors: Chen, Zhen-zhou, Huang, Wang, Chai, Ning-hui, Qiu, Yu-hao, Wei, Zheng-qiang
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.08.2022
• Subjects: Medicine; Medicine & Public Health; Original Article; Surgery; Surgical Oncology; NOSES; Minimally invasive surgery; Double stapling technique; Double angle anastomosis; Colorectal cancer
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-022-02519-2

Purpose We introduced a novel colorectal anastomotic technique, double-angle anastomosis combined with the double stapling technique (DAA-DST), to simplify the anastomosis step during natural orifice specimen extraction surgery (NOSES) and compared its safety and effectiveness with purse string anastomosis combined with the double stapling technique (PSA-DST). Methods Between January 2018 and March 2021, 63 patients with colorectal cancer underwent NOSES with DAA-DST or PSA-DST. We compared the perioperative and oncological outcomes between the groups. Results There were no significant differences in the operation time, blood loss, time to first passage of flatus and excrement or hospital stay duration between PSA-DST and DAA-DST groups. The overall postoperative complication rates were similar (DAA-DST vs PSA-DST, 21.2% vs 26.7%, p  = 0.78), including the rate of anastomotic leakage (6.1% vs 10%, p  = 0.91). The rate of successful DAA-DST was higher than that of PSA-DST (100% vs 93.3%). The DAA-DST group had a lower rate of positive drain fluid culture than the PSA-DST group (18.2% vs 26.7% p  = 0.61). Recurrence (3.01% vs 6.67%, p  = 0.93) and metastasis rates (6.06% vs 6.67%, p  = 0.98) were similar between the groups. Conclusion DAA-DST is a safe and effective procedure and can simplify the procedure of NOSES.