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May 1979

Low Anterior Anastomosis With Surgical Stapler

Arch Surg. 1979;114(5):639. doi:10.1001/archsurg.1979.01370290089021

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To the Editor.—The article by Lepreau in the December 1978 issue of the Archives (113:1479) describes a technique for low anterior resection using a mechanical stapling device. Between January 1978 and September 1978, at four of our University Hospitals, 20 patients (16 male, 4 female) underwent low anterior resections performed with the auto suture model EEA Anastomotic Stapler. The resected lesions were 8 to 13 cm above the anal verge, and the completed anastomosis was 5 to 8 cm above the anal verge. Four patients required loop transverse colostomies at the time of resection because of technical difficulties with the anastomosis.

Postoperatively there were ten clinically apparent anastomotic leaks. Three were treated with loop transverse colostomies and seven were managed conservatively. All of the loop colostomies (seven) were ultimately closed. All patients (20) were ultimately continent.

The technical difficulties are as outlined by Lepreau. We have also encountered difficulty

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