Some clinical and technical aspects of circular stapled anastomoses of rectum and oesophagus.

A complete 8-year experience using the circular stapling instrument is described; 109 rectal and 59 oesophageal anastomoses were performed. Intra-operative problems included two suspected rectal leaks, damage to the tissues in two patients when using too large an instrument, cardiac arrythmias in one patient, precipitated by contact between the heart and the instrument, one instrument/operator failure, and inversion of the muscle layer was incomplete in three oesophageal anastomoses. Postoperative complications included two leaks, seven strictures, seven abscesses and one patient required reoperation. There were no deaths attributable to the use of the instrument or the method of anastomosis. The instrument has allowed satisfactory anastomoses to be performed in relatively inaccessible sites.