Ann Coloproctol.  2023 Jun;39(3):231-241. 10.3393/ac.2021.00906.0129.

Outcomes of side-to-end versus end-to-end colorectal anastomosis in nonemergent sigmoid and rectal cancers: a randomized controlled clinical trial

• Habeeb TA
• Mohammad H
• Wasefy T
• Mansour MI

• KMID: 2543347
• DOI: http://doi.org/10.3393/ac.2021.00906.0129

Abstract

Purpose
The outcomes of open colorectal anastomosis of side-to-end versus end-to-end in nonemergent sigmoid and rectal cancer surgery in adults were compared.
Methods
A randomized controlled trial on individuals with sigmoid and rectal cancers was conducted between September 2016 and September 2018.
Results
The mean age was 62.58±12.3 years in the side-to-end anastomotic (SEA) group and 61.03±13.98 years in the end-to-end anastomotic (EEA) group. Except for the operative time, intraoperative data revealed no significant differences between the studied groups, and the SEA group revealed that the mean anastomotic time was significantly shorter. Perioperative blood loss, length of stay, reoperation, inpatient death, infection, and bleeding were significantly associated with leakage. There is a statistically significant change regarding the range of bowel frequency in the EEA group only (P=0.04). There is a statistically significant difference regarding incontinence for flatus in the SEA group only (P≤0.001). A statistically significant change in both groups regards incontinence for liquid stools (P≤0.001) and clustering of stools (P≤0.001 and P=0.043). The quality of life in the SEA group significantly dropped at 6 months and then returned to baseline as regards to physical well-being (PWB), functional well-being (FWB), and colorectal cancer symptoms (CCS) with no difference as regards SWB and EWB, while in the EEA group, the exact change happened only as regard PWB and FWB, but SWB and CCS percentage did not return to baseline.
Conclusion
The SEA group offers a safe alternative approach to the EEA group.

Keyword

Colorectal anastomosis; Leakage; Quality of life; Rectal neoplasms; Stapler