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APPLICATION
OF MECHANICAL SUTURE IN THE SURGERY OF RECTAL CANCER
Stanojević
G, Mihailović D, Miljković D, Marić, D, Branković B.
Surgical
Clinic Clinical Center Niš, Niš, Serbia and Montenegro
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ABSTRACT
The
results of the clinical investigation in patients operated for rectal
cancer with resection methods applying the mechanical suture device
were presented in the paper, with examined postoperative complications
and mortality. The investigation included 102 surgical patients
with preoperative confirmed histopathologic diagnosis of rectal
carcinoma. The patients were staged as: 7.8% Dukes A; 49% Dukes
B; 38% Dukes C; 5.2% Dukes D. There were 42% well differentiated,
50% moderately differentiated and 8% poorly differentiated tumors.
The examined group was divided into 2 subgroups in relation to the
height of the anastomosis, determined by the anorectal line. There
were 48 (47%) cases with high anastomoses and 54 (53%) with low
anastomoses. Anastomosis dehiscence as the cause of morbidity was
observed in 10 (9.8%) cases. In the subgroup with high anastomoses
there were 1.9% cases of fistulae, while the corresponding percent
in those with low anastomoses was 7.9%. Total mortality was 5,9%
(6 patients). Four patients died of cardiocirculatory events, two
of cardiac insufficiency and two of pulmonary embolism. The consequences
of low anastomosis dehiscence were the cause of death in two cases.
Mechanical suture in the rectal carcinoma surgery allows for a significantly
higher number of sphincter-preserving interventions and produces
acceptable frequency of postoperative complications and mortality. |
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Keywords:
Rectal cancer, Rectal anastomoses, Mechanical sutures |
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