Pubblicato su Techniques in Coloproctology (Epub ahead of print) “A pull-through delayed high coloanal anastomosis new tricks to refresh an old procedure” Bianco F, De Franciscis S, Belli A, Ragone V, Romano GM.

A pull-through delayed “high” coloanal anastomosis: new tricks to refresh an old procedure.

The pull-through two-staged delayed coloanal anastomosis (DCA) was reported for the first time in 1961 (TURNBULL-CUTAIT-TURNBULL/FAZIO/CUTAIT). Recently some authors have proposed DCA both as salvage surgery and as primary treatment for low rectal cancer patients (Remzi, Jarry, Biondo). In order to improve outcome and indications we performed a slightly modified technique with higher coloanal anastomosis without protective stoma that led to encouraging results both in terms of early complications and functional results in patients with low-lying rectal cancer. We present 5 cases with a minimum follow up of 24 months in order to evaluate long-term functional results and compare different reconstructive procedures such as standard DCA, immediate coloanal anastomosis or colonic J-pouch. These outcomes were strictly related to scrupulous attention to technical details; a higher anastomosis and a better sphincter contraction, due to absence of mesocolic tissue inside the anal canal, are the key points of the proposed procedure.

http://link.springer.com/article/10.1007/s10151-015-1273-x