EP606 - End-to-Side Colorectal Stapler Anastomosis (reverse-Baker) as a Safe and Acceptable Alternative Following Colorectal Resection. A Single Institution Experience

ePoster Presenter(s)

• 

  Francisco M. Abarca-Rendon (he/him/his)

  COLON AND RECTAL SURGEON
  OMNI HOSPITAL
  guayaquil, Guayas, Ecuador

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.

  View ePoster

Senior Author(s)

• FA

  Francisco Abarca Aguilar, n/a

  COLON AND RECTAL SURGEON
  OMNI HOSPITAL
  guayaquil, Guayas, Ecuador

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.

Author(s)

• GP

  GUILLERMO PEREZ, n/a

  COLON AND RECTAL SURGEON
  OMNI HOSPITAL
  guayaquil, Guayas, Ecuador

  Disclosure information not submitted.
• GA

  GUIDO AGUILERA, n/a

  ANESTHESIOLOGIST
  OMNI HOSPITAL
  guayaquil, Guayas, Ecuador

  Disclosure information not submitted.

Purpose/Background:

Background: Traditionally, straight end-to-end colorectal anastomosis has been the main anastomotic method following colorectal resection, but in some cases the end-to-end (EEA) stapler will not reach the stapled rectal cuff, or in some cases surgeons need to improvise to perform a perfect colorectal anastomosis.

Objective: To evaluate the safety of end-to-side colorectal stapler anastomosis after colorectal resection.

Methods/Interventions:

Design: Retrospective, single arm

SETTINGS: This study was conducted at a single tertiary center.

PATIENTS: All patients with any left-sided colorectal resection and end-to-side stapler colorectal anastomosis regardless of the indications from July 2023 to July 2024 were included.

MAIN OUTCOME MEASURES: Primary endpoint was safety of end-to-side stapler colorectal anastomosis following colorectal resection.

Results/Outcomes:

Results: 50 patients underwent end-to-side stapler colorectal anastomosis. The mean age was 54.6 years. 58% were females. The indications for colorectal resection were diverticulitis (46%), colon cancer (32%), rectal cancer (14%), perforation (8%). Open surgery was performed in 18 (36%) cases and laparoscopic surgery was performed in 32 (64%) cases. A 29 mm EEA was used for all colorectal anastomosis. Of all 50 patients, only 9 (18%) had complications; of these, 4% had anastomosis related complications (clinical leaks), other complications include ileus (10%), SSI (2%) and hematoma (2%). Only 5 patients had proximal diversion. Mean length of stay after surgery was 4.24 days.

LIMITATIONS: This is a non-randomized retrospective study, single institution experience.

Conclusion/Discussion:

Conclusions: Our study concludes that end-to-side colorectal stapler anastomosis (reverse-baker) is a safe alternative following colorectal resection, with low complication rates, especially with the benefit of no-crossing staples lines.

End-to-side colorectal anastomosis
Figure 1. Anastomosis from the side of the rectum (anterior wall) to the end of the left colon

Sagittal tomographic view
Figure 2. Tomographic sagittal view of the end-to-side colorectal anastomosis