Side-to-End Versus End-to-End Colorectal Anastomosis Following Anterior Resection of Rectal and Recto-Sigmoid Cancers, A Randomized Clinical Trial
Abdwahed, M., Mohsen, S., Farrag, A. (2022). Side-to-End Versus End-to-End Colorectal Anastomosis Following Anterior Resection of Rectal and Recto-Sigmoid Cancers, A Randomized Clinical Trial. EKB Journal Management System, 89(1), 5116-5122. doi: 10.21608/ejhm.2022.261800
Mohamed Abdwahed; Sherief M. Mohsen; Ahmed M. Farrag. "Side-to-End Versus End-to-End Colorectal Anastomosis Following Anterior Resection of Rectal and Recto-Sigmoid Cancers, A Randomized Clinical Trial". EKB Journal Management System, 89, 1, 2022, 5116-5122. doi: 10.21608/ejhm.2022.261800
Abdwahed, M., Mohsen, S., Farrag, A. (2022). 'Side-to-End Versus End-to-End Colorectal Anastomosis Following Anterior Resection of Rectal and Recto-Sigmoid Cancers, A Randomized Clinical Trial', EKB Journal Management System, 89(1), pp. 5116-5122. doi: 10.21608/ejhm.2022.261800
Abdwahed, M., Mohsen, S., Farrag, A. Side-to-End Versus End-to-End Colorectal Anastomosis Following Anterior Resection of Rectal and Recto-Sigmoid Cancers, A Randomized Clinical Trial. EKB Journal Management System, 2022; 89(1): 5116-5122. doi: 10.21608/ejhm.2022.261800

Side-to-End Versus End-to-End Colorectal Anastomosis Following Anterior Resection of Rectal and Recto-Sigmoid Cancers, A Randomized Clinical Trial

The Egyptian Journal of Hospital Medicine
Article 154, Volume 89, Issue 1, October 2022, Page 5116-5122  XML PDF (608.93 K)
Document Type: Original Article
DOI: 10.21608/ejhm.2022.261800
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Authors
Mohamed Abdwahed; Sherief M. Mohsen; Ahmed M. Farrag
Abstract
Background: Recto-sigmoid and rectal tumors are now treated with anterior resection as the gold standard. However, anastomotic leakage and the temporary use of a covering stoma after resection provide a significant problem for colorectal surgeons. The technique of anastomosis is critical in preventing anastomotic leakage. Some surgeons believe that side-to-end anastomosis is superior to end-to-end anastomosis, whereas others do not.
Objective: The current study was aimed to compare the surgical outcome, particularly the incidence of anastomosis leakage, between two groups using various surgical techniques.
Patients and Methods: This is a prospective randomized clinical trial (RCT) that included 107 patients with recto-sigmoid and rectal malignancies. Between March 2018 and March 2022, patients were treated at Ain-Shams University Hospitals with elective laparoscopic anterior resection. Patients were divided into two groups using sealed envelope method. Following anterior resection, Group A had side-to-end anastomosis (SEA) using a double stapling technique, while Group B had end-to-end anastomosis (EEA) utilizing a trans-anal circular stapler.
Results: After anterior resection, Group A (35 men and 20 women) received side-to-end anastomosis, while Group B (31 men and 21 women) underwent end-to-end anastomosis. There were no statistically significant differences between the two groups as regard body mass index (BMI), smoking and tumor location. The end-to-end anastomosis group had a statistically significantly longer mean operative time than the side-to-end anastomosis group (251.71 vs. 227.15 minutes, respectively) (P value 0.001). There was no statistically significant difference in anastomotic leakage between the two groups, with a P value of 0.262 (2 instances, 3.6% in SEA Group vs. 5 cases, 9.6% in EEA Group).
Conclusion: It could be concluded that side to end colorectal anastomosis could be an alternative to end to end with shorter operative time.
Keywords
anastomotic leakage; anterior resection; side to end anastomosis
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