The study evaluates the feasibility and advantage of modified laparoscopic double-staple anastomosis technique which to eliminate the 'dog ears' in laparoscopic rectal anterior resection.
Laparoscopic surgeons commonly make rectal transection intracorporeally by laparoscopic linear stapler during rectal anterior resection and perform an end-to-end anastomosis by circular stapler. But the so-called 'dog ears', two stapled corners of the rectal stump after laparoscopic linear transection of rectum, are very common. The lateral intersections of double-stapled anastomoses are structural weak spot area, and they are considered to be the potential ischemic areas leading to anastomosis leakage and the possible sites occurring local recurrence. Previous study reported a modified technique for rectal reconstruction during open surgery, and they could use circular stapler to eliminate the staple line on the rectal stump and cut off the 'dog ears'. But because of the narrow pelvic cavity, it is very difficult to perform this technique in laparoscopic rectal surgery and there is no related report on laparoscopic application. In this study, we evaluates the feasibility and advantage of modified laparoscopic double-staple anastomosis technique, to eliminate the "dog ears" in laparoscopic rectal anterior resection by laparoscopic suturing on the staple line.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
250
a modified double-stapling technique with eliminating the dogears in laparoscopic anterior resection
a traditional double-stapling technique without eliminating the dogears in laparoscopic anterior resection
anastomotic leakage rate
Time frame: 30 days since the date of surgery
Intra-operative and post-operative complications
Time frame: 30 days since the date of surgery
post-operative Mortality
Time frame: 30 days since the date of surgery
re-operation rate
Time frame: 30 days since the date of surgery
QLQ 30
Time frame: at postoperative 3,6 and 12 months
Wexner's scoring
Time frame: at postoperative 3,6 and 12 months
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