M A Majbar1, L Courtot2, L Dahbi-Skali1, A Rafik1, P O Jouppe2, D Moussata2, A Benkabbou1, R Mohsine1, M Ouaissi2, A Souadka3. 1. Digestive Surgical Oncology Department, National Institute of Oncology, Ibn Sina University Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco. 2. Department of Digestive, Oncological, Endocrine, Hepato-Biliary, Pancreatic, and Liver Transplant Surgery, Trousseau Hospital, Tours, France. 3. Digestive Surgical Oncology Department, National Institute of Oncology, Ibn Sina University Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco. Electronic address: a.souadka@um5s.net.ma.
Abstract
BACKGROUND: Delayed colo-anal anastomosis (DCA) is an underused technique rarely performed after resection of primary low rectal adenocarcinoma. The objective of this study was to compare the short-term outcomes of DCA and classical colo-anal anastomosis (CAA). METHODS: This is a retrospective comparative study carried out at two tertiary centres in Morocco and France. It included all patients who underwent colo-anal anastomosis after complete mesorectal excision for primary rectal adenocarcinoma between January 2018 and December 2019. The main outcomes were 90-day morbidity and rates completing the surgical steps of DCA and CAA. RESULTS: Among 215 rectal resections, 45 patients received colo-anal anastomosis, including 19 DCA and 26 CAA. Seventeen patients in the DCA group completed the two steps compared to 16 in the CAA group (89.5% vs. 61.5%, P=0.04). The rates of severe complications (26.9% vs. 26.3%, P=0.96) and anastomotic leakage (42.3% vs. 31.6%, P=0.46) were not different between the two groups. CONCLUSION: This study showed that DCA was associated with a higher rate of completing the two surgical steps, with no difference in overall and severe morbidity. DCA may be a strong alternative to classical colo-anal anastomosis.
BACKGROUND: Delayed colo-anal anastomosis (DCA) is an underused technique rarely performed after resection of primary low rectal adenocarcinoma. The objective of this study was to compare the short-term outcomes of DCA and classical colo-anal anastomosis (CAA). METHODS: This is a retrospective comparative study carried out at two tertiary centres in Morocco and France. It included all patients who underwent colo-anal anastomosis after complete mesorectal excision for primary rectal adenocarcinoma between January 2018 and December 2019. The main outcomes were 90-day morbidity and rates completing the surgical steps of DCA and CAA. RESULTS: Among 215 rectal resections, 45 patients received colo-anal anastomosis, including 19 DCA and 26 CAA. Seventeen patients in the DCA group completed the two steps compared to 16 in the CAA group (89.5% vs. 61.5%, P=0.04). The rates of severe complications (26.9% vs. 26.3%, P=0.96) and anastomotic leakage (42.3% vs. 31.6%, P=0.46) were not different between the two groups. CONCLUSION: This study showed that DCA was associated with a higher rate of completing the two surgical steps, with no difference in overall and severe morbidity. DCA may be a strong alternative to classical colo-anal anastomosis.
Authors: Aya El Yaakoubi; Salma Lahmadi; Amine Benkabbou; Raouf Mohsine; Abdelkader Belkouchi; Tijani El Harroudi; Hadj Omar El Malki; Abdelmalek Hrora; Amine Souadka; Mohammed Anass Majbar Journal: Ann Med Surg (Lond) Date: 2022-08-03