Key result
Double-stapling technique anastomosis with a polyglycolic acid sheet significantly reduced the rate of anastomotic leakage compared to the conventional method (2.3% vs 18.6%, p=0.030) in a propensity score-matched cohort of patients with left-sided colorectal cancer.
Why the study?
Does DST anastomosis with a PGA sheet reduce anastomotic leakage in patients with left-sided colorectal cancer?
Cohort (n=356)
No
Does DST anastomosis with a PGA sheet reduce anastomotic leakage in patients with left-sided colorectal cancer?
Absolute Event Rate: 2.3% vs 18.6%
p-value: p=0.030
The use of a polyglycolic acid sheet during double-stapling technique anastomosis may significantly reduce the rate of anastomotic leakage in left-sided colorectal cancer surgery.
PGA sheet reinforcement was associated with lower anastomotic leakage after DST; leaves open efficacy pending randomized trials.
BACKGROUND: To prevent anastomotic leakage in patients with left-sided colorectal cancer who underwent double-stapling technique (DST) anastomosis, we investigated a new method: DST anastomosis with a polyglycolic acid (PGA) sheet. This procedure has been shown to have the potential to decrease the rate of anastomotic leakage. However, due to the small number of cases enrolled in our previous study, it was not possible to compare the outcomes of the new and conventional procedures. The aim of this study was to evaluate the effect of the PGA sheet on preventing anastomotic leakage in patients with left-sided colorectal cancer who underwent DST anastomosis by retrospectively comparing the anastomotic leakage rate between the PGA sheet and conventional groups. METHODS: A total of 356 patients with left-sided colorectal cancer who underwent DST anastomosis during surgery at Osaka City University Hospital between January 2016 and April 2022 were enrolled in this study. Propensity score matching was performed to reduce the confounding effects secondary to imbalances in the use of PGA sheets. RESULTS: The PGA sheet was used in 43 cases (PGA sheet group) and it was not used in 313 cases (conventional group). After propensity score matching, the incidence of anastomotic leakage in the PGA sheet group was significantly lower than that in the conventional group. CONCLUSION: DST anastomosis with PGA sheet, which is easy to perform, contributes to the reduction of anastomotic leakage rate by increasing the strength of the anastomotic site.
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Shibutani et al. (2023) conducted a cohort in Left-sided colon or rectal cancer (n=356). Double-stapling technique (DST) anastomosis with a polyglycolic acid (PGA) sheet vs. Conventional double-stapling technique (DST) anastomosis without PGA sheet was evaluated on Anastomotic leakage (propensity score-matched cohort) (p=0.030). Double-stapling technique anastomosis with a polyglycolic acid sheet significantly reduced the rate of anastomotic leakage compared to the conventional method (2.3% vs 18.6%, p=0.030) in a propensity score-matched cohort of patients with left-sided colorectal cancer.
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