RESULTS OF THE DOUBLE STAPLING PROCEDURE IN COLORECTAL SURGERY

In this report we review our results,vith the double stapling techniqu e (DST) in 162 patients with colorectal diseases in an attempt to iden tify some of the potential pitfalls of this new technique. Among these 162 patients, there were 125 patients with colorectal cancer, 25 with chronic ulcerative colitis (UC), 9 with familial adenomatous polyposi s (FAP), 2 with adult Hirschsprung's disease, and 1 with sigmoid colon fistula. A total of 46 anastomoses (28 for rectal cancer, 13 for UC, 3 for FAP, and 2 for adult Hirschsprung's disease) were performed at o r near the dentate line. Of these, 10 had protective diverting colosto my or ileostomy. The results showed that 6 patients with rectal cancer had anastomotic leakage (3.7%); however, 4 of the 6 patients had also received preoperative irradiation. All the leaks healed after the pat ients had undergone diverting colostomy, but 7 patients,vith rectal ca ncer suffered from neurogenic bladder postoperatively (4.3%). Wound in fection occurred in 4 patients (2.5%), anastomotic bleeding in 3 (1.9% ), and anal pain in 1 (0.6%), respectively. One patient with rectal ca ncer and multiple liver metastases died of disseminated intravascular coagulation (DIG). These results thus suggest that the double stapling technique provides a safe anastomosis at or near the dentate line not only for rectal cancer but also for UC, FAP, and adult Hirschsprung's disease.