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Efficacy of intracorporeal reinforcing sutures for anastomotic leakage after laparoscopic surgery for rectal cancer

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Abstract

Background

The aim of the present study was to investigate the efficacy of intracorporeal reinforcing sutures for preventing anastomotic leakage (AL) after laparoscopic surgery for rectal cancer.

Methods

This was a retrospective single-institution study consisting of 201 consecutive patients who underwent laparoscopic proctectomy with double-stapling anastomosis for primary rectal cancer between August 2007 and December 2013. The data for patients who received intracorporeal reinforcing sutures were compared with those of patients who did not receive reinforcing sutures. Patient-, tumor- and surgery-related variables were collected and examined using univariate and multivariate analyses.

Results

The overall incidence of AL was 9.0 % (18/201). No significant correlations were observed between the various clinicopathological factors and the use of reinforcing sutures. The multivariate analyses revealed the distance of the tumor from the anal verge, tumor size and presence of reinforcing sutures to be independent risk factors for AL. We classified the patients into two risk groups using a combination of the tumor site and tumor size: a low-risk group (patients without any risk factors, n = 134) and a high-risk group (patients with one or two risk factors, n = 67). The frequency of AL was significantly lower (p < 0.02) in the patients treated with reinforcing sutures than in those treated without reinforcing sutures in the high-risk group. However, no significant differences were observed in the low-risk group.

Conclusions

The use of intracorporeal reinforcing sutures may reduce the incidence of AL. A prospective randomized trial is required to evaluate the effects of reinforcing sutures in preventing AL.

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Disclosures

Drs Kiyoshi Maeda, Hisashi Nagahara, Masatsune Shibutani, Hiroshi Otani, Kenji Sugano, Ikeya Tetsuro, Yoshihito Iseki, Katsunobu Sakurai, Takahiro Toyokawa, Kazuya Muguruma, Hiroaki Tanaka, Ryosuke Amano, Kenjiro Kimura and Kosei Hirakawa have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Surgical Oncology, Graduate School of Medicine, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, Japan

    Kiyoshi Maeda, Hisashi Nagahara, Masatsune Shibutani, Hiroshi Ohtani, Katsunobu Sakurai, Takahiro Toyokawa, Kazuya Muguruma, Hiroaki Tanaka, Ryosuke Amano, Kenjiro Kimura, Kenji Sugano, Teturo Ikeya, Yasuhito Iseki & Kosei Hirakawa

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  1. Kiyoshi Maeda
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  2. Hisashi Nagahara
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  3. Masatsune Shibutani
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  13. Yasuhito Iseki
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  14. Kosei Hirakawa
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Correspondence to Kiyoshi Maeda.

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Maeda, K., Nagahara, H., Shibutani, M. et al. Efficacy of intracorporeal reinforcing sutures for anastomotic leakage after laparoscopic surgery for rectal cancer. Surg Endosc 29, 3535–3542 (2015). https://doi.org/10.1007/s00464-015-4104-2

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  • DOI: https://doi.org/10.1007/s00464-015-4104-2

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