Sutureless open low anterior resection with total mesorectal excision for rectal cancer with the use of the electrothermal bipolar vessel sealing system
Andreas Manouras, George Filippakis, Dimitrios Tsekouras, Emmanuel Lagoudianakis, Michael Genetzakis, Haridimos Markogiannakis, Georgia Kafiri, Nikolaos Pararas, Dimitrios Papanikolaou, Konstantinos Toutouzas, Stylianos Katsaragakis
Med Sci Monit 2007; 13(5): CR224-230
Available online: 2007-05-04
Background: There is no report of electrothermal bipolar vessel sealer utilization in rectal surgery. The objective here was to evaluate the results of the use of this device in open low anterior resection for rectal cancer regarding reduction of operative time, hemostasis, and postoperative complications compared with the conventional technique. An additional aim was to describe and standardize this operative technique.
Material/Methods: All open low anterior resections with total mesorectal excision for rectal cancer performed by the same surgical team from January 2003 to December 2003 were reviewed. Patients were divided in two groups: those operated with the classic technique (group A) and those with a bipolar vessel sealer (group B). Main outcomes measured were operative and hospitalization time, intraoperative blood loss, postoperative drainage volume and duration, postoperative complications, perioperative blood transfusions, and fi nal outcome.
Results: Forty-one patients were included (group A: 19, group B: 22). The groups were similar in demographics, TNM classifi cation, number of lymph nodes dissected, complications, blood transfusions, hospital stay, and outcome. Comparing group B with group A, operative time (171±10 vs. 203±20 min, p=0.002), intraoperative blood loss (20±6 vs. 60±4 ml,
Keywords: Aged, 80 and over, Adult, Anastomosis, Surgical - methods, Blood Vessels - anatomy & histology, Colectomy - methods, Hemostasis, Surgical - methods, Rectal Neoplasms - surgery, Suture Techniques - instrumentation