Staplers in oncologic surgery increase the incidence of low anterior resections of the rectum: 11-year analysis (1996−2006)

Background Low rectal cancers pose a difficulty in performing a low/ultralow colorectal anastomosis. Stapler techniques of anastomosis are more frequently used due to speed and technically simpler performance of low anastomosis. The goal of the study was to conclude whether the use of staplers has increased the share of continuous rectal resections because of cancer at UHC Zagreb. Methods In the 11-year period (1996−2006) all patients with rectal cancer at the Division of Abdominal Surgery were included in the study. Staplers in rectal surgery were used during the entire study period, but continuously and constantly after year 2000. Results The study involved 413 operated patients which included 149 low anterior resections, 156 Miles' operations and the remaining ones were Hartmann's and palliative operations. Over the years the number of all operations constantly increased with an increasing incidence of low rectal resections. The incidence of Miles' operation remained unchanged with value of around 40%. Conclusions Continuity restoration after rectal resection increases the quality of life with equal oncologic safety in comparison with abdominoperineal resection. With the constant use of staplers in oncologic rectal surgery there is an increasing incidence of low rectal resections. Unfortunately, the incidence of Miles' operations remains constant.