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CC BY-NC-ND 4.0 · Journal of Coloproctology 2023; 43(01): 056-060
DOI: 10.1055/s-0043-1764166
Technical Note

Scarless Two-Stage Delayed Coloanal Anastomosis: A Technique Description

Hani Bendib 
1   Department of Oncologic Surgery, Debussy Clinic, Algiers 1 University, Algeria, Algeria
,
Hind Oukrine
1   Department of Oncologic Surgery, Debussy Clinic, Algiers 1 University, Algeria, Algeria
,
Nabil Djelali
1   Department of Oncologic Surgery, Debussy Clinic, Algiers 1 University, Algeria, Algeria
,
Said Lahrech
1   Department of Oncologic Surgery, Debussy Clinic, Algiers 1 University, Algeria, Algeria
,
Ameur Elbahi
1   Department of Oncologic Surgery, Debussy Clinic, Algiers 1 University, Algeria, Algeria
,
Chemseddine Chekman
1   Department of Oncologic Surgery, Debussy Clinic, Algiers 1 University, Algeria, Algeria
,
Abdelghani Azzouz
1   Department of Oncologic Surgery, Debussy Clinic, Algiers 1 University, Algeria, Algeria
,
Abdelkrim Anou
2   Department of Oncologic Surgery, CLCC Blida, Blida 1 University, Algeria
,
Azeddine Djennaoui
1   Department of Oncologic Surgery, Debussy Clinic, Algiers 1 University, Algeria, Algeria
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Abstract

Introduction In current clinical practice, immediate coloanal anastomosis (ICA) remains the standard technique for restoring the gastrointestinal tract following coloproctectomy for low rectal cancer. This anastomosis still requires a temporary diverting stoma to decrease the postoperative morbidity, which remains significantly high. As an alternative, some authors have proposed a two-stage delayed coloanal anastomosis (TS-DCA). This article reports on the surgical technique of TS-DCA.

Methods The case described is of a 53-year-old woman, without any particular history, in whom colonoscopy motivated by rectal bleeding revealed an adenocarcinoma of the low rectum. Magnetic resonance imaging showed a tumor ∼ 1 cm above the puborectalis muscle, graded cT3N + . The extension workup was negative. Seven weeks after chemoradiotherapy, a coloproctectomy with total mesorectal excision (TME) was performed. A TS-DCA was chosen to restore the digestive tract.

Conclusion Two-stage delayed coloanal anastomosis is a safe and effective alternative for restoring the digestive tract after proctectomy for low rectal cancer. Recent data seem to show a clear advantage of this technique in terms of morbidity.

Keywords

delayed coloanal anastomosis - Baulieux technique - proctectomy - total mesorectal excision - diverting stoma - Turnbull and Cutait procedure

Author Contributions

H. B.: Drafting the article and revising it critically for important intellectual content as well as final approval of the version to be submitted.


H. O., N. D., S. L., A. E., C. C., A. A., A. A., and A. D.: Revising the article critically for important intellectual content and final approval of the version to be submitted.




Publikationsverlauf

Eingereicht: 19. Oktober 2022

Angenommen: 23. Januar 2023

Artikel online veröffentlicht:
22. März 2023

© 2023. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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