ArticleTechniques in coloproctology2020
Analysis of the impact of EEA stapler size on risk of anastomotic complications in colorectal anastomosis: does size matter?
Article in Techniques in coloproctology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Technique and results of novel intracorporeal "overlap" colorectal anastomosis for laparoscopic and robotic surgery.Techniques in coloproctology · 2026Observational
- Importance of the diameter of the mechanical suture in rectal surgery in relation to benign anastomotic stenosis. Cross-sectional observational study.Techniques in coloproctology · 2025Observational
- Rectal stenosis after circular mechanical anastomosis; the influence of stapler size.Surgical endoscopy · 2024Observational
- The impact of circular stapler size on the risk of anastomotic stricture following total mesorectal excision in rectal cancer patients: A retrospective cross-sectional study.Health science reports · 2023Article
- Impact of powered circular stapler on anastomotic leak after anastomosis to the rectum: a propensity score matched study.International journal of colorectal disease · 2023Article
- Real-life introduction of powered circular stapler for esophagogastric anastomosis: cohort and propensity matched score study.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2023Article
- The effect of circular stapler size on anastomotic stricture formation in colorectal surgery: A propensity score matched study.PloS one · 2023Article
- The Colorectal Anastomosis: A Timeless Challenge.Clinics in colon and rectal surgery · 2023Review
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundColorectal anastomotic complications are dreaded and dramatically affect outcomes. Causes are multifactorial, with the size of the end-to-end anastomosis (EEA) stapler a modifiable factor and potential target for risk reduction. Our goal was to examine the impact of the EEA stapler size on the risk of anastomotic complications in left-sided colorectal resections.
methodsA prospective divisional database was reviewed for consecutive elective left-sided resections with a colorectal anastomosis using an EEA stapler from January 2013 May 2018 inclusive. Patients were stratified into 25-29 mm or 30-33 mm cohorts. Patient and disease demographics, operative variables, and postoperative outcomes were evaluated. The main outcome measures were the rate and factors associated with anastomotic complications.
resultsFour hundred seventy-three cases were evaluated, 185 ( 39.1%) were in the 25-29 mm group and 288 (60.9%) in the 30-33 mm group. Patients were comparable in demographics and operative variables. More males were anastomosed with the 30-33 mm than with the 25-29 mm stapler (57.6% vs 28.6%, p < 0.01). Significantly more patients developed an anastomotic stricture with the 25-29 mm than with the 30-33 mm staplers (7.1% vs. 2.1%; p = 0.007). There was no significant difference in leak rates or reoperation/interventions between groups. On logistic regression, neither gender, operative indication nor approach were associated with anastomotic leak, readmission, or reoperation/intervention. Stapler size remained significantly associated with stricture (p = 0.032).
conclusionsThe 25-29 mm EEA staplers were associated with an increased rate of anastomotic stricture compared to 30-33 mm staplers in left-sided colorectal anastomoses. As stapler size is a simple process measure that is easily modifyable, this is a potential target for improving anastomotic complication rates. Further controlled trials may help assess the impact of stapler size on improving patient and quality outcomes.
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