Comparison of double stapling technique and single stapling technique used in transanal pull-through rectal resection operations for ultra low rectal cancer

Abstract:

Objective：To study advantages and disadvantages of single stapling technique（SST） and double stapling technique（DST） in transanal pull-through rectal resection operations for ultra low rectal cancer. Methods：Totally 1 138 patients with rectal cancer were treated in our department from July 2008 to July 2011.One hundred and thirteen cases underwent transanal pull-through rectal resec－tion operations：49 cases by SST and 64 cases by DST. Operative time，postoperative complication incidences including anastomotic leakage，bleeding and stenosis，pelvic floor recurrence within 1-4 years，hospitalization duration and costs were analyzed and com－pared between the two groups. Advantages and disadvantages of the two stapling techniques were analyzed statistically. Results：Differ－ences in average operative time and postoperative hospitalization duration between the two groups were not statistically significant（op－erative time t=0.172，P=0.864；average hospitalization duration Z=-0.562，P=0.547）. Postoperative complications：differences in anas－tomotic leakage between the two groups were statistically significant（ χ2=6.592，P=0.01）；differences in other complications between the two groups were not statistically significant（ χ2=0.037，P=0.848）. Differences in pelvic floor local recurrence within 1-4 years between the two groups were not statistically significant （ χ2=1.839，P=0.175）. Differences in average hospital cost were statistically significant（Z=-5.782，P=0.00）. Conclusions：Transanal pull-through rectal resection has become a commonly used technique for ultra-low rectal cancer. With the advantages of simpler and safer manipulation，lower cost and recurrences and more complete resection，SST is superior to DST and is worthy of clinical application.