Abdelkader Ahmed, Akinlade Abdulsalam, Luqhman Aashir, Thomas Georgy, Naveed Waleed, Vijayakumar Cyrilkumaar, Chandran Anupam, Mahmoud Mubariz, Ahmad Muzaffar
Surgery, Northern Lincolnshire and Goole NHS Foundation Trust (NLaG), Hull, GBR.
General Surgery, Scunthorpe General Hospital, Scunthorpe, GBR.
Cureus. 2025 May 5;17(5):e83496. doi: 10.7759/cureus.83496. eCollection 2025 May.
Aim The objective of this study was to evaluate the safety and efficacy of the modified triple-staple technique in anterior resection for colorectal cancer patients and Hartmann's reversal surgeries done by a single surgeon. We hypothesized that by using this technique and omitting the purse-string suture, we could reduce operative time and enhance ergonomic benefits. The study was conducted in accordance with local clinical governance unit protocols and adhered to the Strengthening the Reporting of Cohort Studies in Surgery (STROCSS) guidelines. Methods This retrospective cohort study aimed to evaluate patients who underwent colorectal anastomosis as part of either Hartmann's reversal or colorectal cancer surgeries over a 15-year period, from January 2010 to January 2025. A total of 132 patients who underwent anterior resection for colorectal cancer or Hartmann's reversal were included. A modified triple staple technique for end-to-end colorectal and coloanal anastomosis was performed without the use of a purse-string suture on both the proximal and distal segments. The safety and efficacy of this technique were assessed by monitoring complication rates, including intraoperative complications, anastomotic leaks, and strictures. Results There were no major intraoperative complications reported. Anastomotic leakage occurred in 11 patients (8%), while strictures developed in 2 patients (2%). Postoperative abdominal collections were observed in three patients (2%), and postoperative ileus occurred in nine patients (7%). Conclusion The modified triple stapler technique for end-to-end anastomosis offers a safe and effective alternative to the conventional purse-string double stapler technique.
目的 本研究的目的是评估改良三吻合器技术在结直肠癌患者前切除术和由单一外科医生进行的哈特曼氏回纳手术中的安全性和有效性。我们假设，通过使用该技术并省略荷包缝合，可以减少手术时间并提高人体工程学效益。本研究是根据当地临床治理单位的方案进行的，并遵循加强外科队列研究报告（STROCSS）指南。方法 这项回顾性队列研究旨在评估在2010年1月至2025年1月的15年期间接受结直肠吻合术作为哈特曼氏回纳术或结直肠癌手术一部分的患者。总共纳入了132例行结直肠癌前切除术或哈特曼氏回纳术的患者。采用改良三吻合器技术进行结直肠端端和结肠肛管吻合，近端和远端均不使用荷包缝合。通过监测并发症发生率，包括术中并发症、吻合口漏和狭窄，评估该技术的安全性和有效性。结果 未报告重大术中并发症。11例患者（8%）发生吻合口漏，2例患者（2%）出现狭窄。3例患者（2%）出现术后腹腔积液，9例患者（7%）发生术后肠梗阻。结论 改良三吻合器端端吻合技术是传统荷包双吻合器技术的一种安全有效的替代方法。
