SIDE TO END ANASTOMOSIS IN RECTAL CANCER BY PCEEA INSTRUMENT

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  • 機械吻合による結腸直腸側端吻合術

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We report here a technique for side to end anastomosis on colorecal anastomosis (Baker's method) using a PCEEA (PREMIUM C EEA Stapler) . Reconstruction of colorectal anastomosis in the original Baker's method has been by hand suture. The PCEEA, which is improved from the original EEA stapler (end to end anastomosis stapler), has several new functions. Some points of the new design are as follows : The top portion of the shaft and anvil are removed from the instrument, and there is a separate disposable trocar which is inserted into the shaft. The trocar facilitates insertion through the closed lumen. Using the trocar's function, side to end anastomosis by Baker's method can be easily done. Adavantages of the side to end anastomosis using the PCEEA instrument over end to end anastomosis are : 1) greater technical ease, 2) a more secure anastomosis, and 3) a larger anastomotic lumen. The zero anastomotic leak rate of clinical cases undergoing side to end anstomosis on colorectal anastomosis was better than that in other methods using the usual pursestring EEA technique. We recommend this modified Baker's method using PCEEA as adquate surgical intervention for reconstruction in patients with lower sigmoid colon and upper and middle rectal cancer.

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