[Mechanical circular colorectal anastomosis using a transanal approach. Apropos of a series of 51 cases].

Automatic circular suture forceps offer new technical possibilities for the confection of colorectal anastomosis. A retrospective study was conducted in 51 patients, representing a homogeneous group of anastomoses performed by the same surgeon using the same operative technique and with routine review by barium enema examination on the 8 th postoperative day. Technical difficulties during operation were encountered in 10 patients (19.6%) requiring supplementary sutures in 3 cases and protective colostomies in 3 others. Review examinations revealed anastomotic dehiscence in 7 cases (13.7%), only 3 (5.9%) of these radiologic fistulae provoking clinical manifestations, and only one of these (1.9%) necessitating recovery operation. Perfect compliance with conditions of use of the mechanical forceps and a minute technique identical to those of manual sutures produced excellent early result with circular mechanical suturing using EEA forceps when compared with manual suturing methods. This was particularly true in Goligher's series in which there were 51% of radiologic fistulae. Under certain difficult conditions, the use of EEA forceps simplifies performance of a colorectal anastomosis, mechanical anastomosis using the circular forceps constituting an undeniable technical progress in colorectal surgery with conservation of anal sphincter.