Safe anastomosis in laparoscopic and robotic low anterior resection for rectal cancer: a narrative review and outcomes study from an expert tertiary center

Eur J Surg Oncol. 2015 Feb;41(2):175-85. doi: 10.1016/j.ejso.2014.10.060. Epub 2014 Nov 11.

Abstract

Anastomotic leak and stricture formation are recognised complications of colorectal anastomoses. Surgical technique has been implicated in its aetiology. The use of innovative anastomotic techniques and technical standardisation may facilitate risk modification. Early detection of complications using novel diagnostic tests can lead to reduction in delay of diagnosis as long as a standard system is used. We review our practice for creation a safe anastomosis for minimal invasive rectal cancer resection. Several technical points discussed and evaluated based on the evidence. We propose several recommendations aiming to standardize the technique and to minimize anastomotic complications.

Keywords: Anastomosis; Laparoscopic; Rectal cancer.

Publication types

  • Review

MeSH terms

  • Anal Canal / pathology
  • Anal Canal / surgery*
  • Anastomosis, Surgical / adverse effects
  • Anastomosis, Surgical / methods
  • Anastomotic Leak / etiology
  • Anastomotic Leak / prevention & control*
  • Colon / pathology
  • Colon / surgery*
  • Constriction, Pathologic / etiology
  • Constriction, Pathologic / prevention & control
  • Drainage
  • Fluid Therapy
  • Humans
  • Laparoscopy / methods
  • Operative Time
  • Rectal Neoplasms / surgery*
  • Rectum / pathology
  • Rectum / surgery*
  • Robotics
  • Stents
  • Surgical Stapling
  • Tertiary Care Centers