REINFORCEMENT OF STAPLE LINE OF COLORECTAL ANASTOMOSIS AS A METHOD OF LEAKEAGE PREVENTION

Abstract

AIM: to decrease anastomotic leakage rate using transanal and transabdominal reinforcing sutures of staple line of colorectal anastomosis. PATIENTS AND METHODS: a prospective randomized trial is started. The main group included patients which underwent anterior or low anterior resection of the rectum with reinforcing of the staple line of colorectal anastomosis using reinforcing sutures on 2, 4, 6, 8, 10 and 12 by conventional dial. The control group consisted of patients without reinforcing of the anastomosis line. RESULTS: from November 2017 to October 2018, 127 patients underwent anterior or low anterior resection of the rectum, 80 of them were included in the study,six were excluded from the study after surgery. Among these 74 patients 40 (54.0 %) were females, mean age was 63.0± 11.0 years. Forty patients consisted the main group, 34 - control. The anastomotic leakage rate in the main group was 7% (3/40), in the control - was 26 % (9/34) (p=0.06). The clinical anastomotic leakage rate in the main group was 3 % (1/40), in the control group - 21 % (7/34) (p=0.03). The anastomotic leakage rate in the main group, after anterior resection of the rectum was 13 % (2/15), in the control - 0 % (0/8) (p=0.8). After low anterior resection the anastomotic leakage rate in the main group was 4 % (1/25), in the control - 35 % (9/26) (p=0.016). Multivariate analysis of risk factors of anastomotic leakage significance associated with male gender (OR 6.88, CI 1,32-of 35.9, p=0,022), positive bubble test (OR 6.26, CI of 1.22-32,2, p=0.028), absence of reinforcing of the anastomosis (OR 4.39, CI 0,96-20,12, p=0,056). CONCLUSION: the reinforcing of colorectal anastomoses decreases anastomotic leakage rate after low anterior resection.