Safe Bowel Anastomosis in Minimal Invasive Surgery for Colorectal Cancer

  • Cheng-Jen MaEmail author
  • Jaw-Yuan Wang


The minimal invasive surgery for colorectal cancer is considered a safe procedure with evolutions of preoperative preparation, antibiotic prophylaxis, surgical technique, surgical devices, and postoperative management in the last decades. It should take notes in details of techniques performed, devices selected, and conditions of bowel where an anastomosis is made and new technology to facilitate making an anastomosis that may help to reduce the occurrence of anastomotic complications, such as bleeding, leakage and dehiscence, stenosis, and fistula which are harmful for patients and have negative impacts on surgical as well as oncological outcomes.


Anastomosis Minimal invasive surgery Colorectal cancer 


  1. 1.
    Paun BC, Cassie S, MacLean AR, Dixon E, Buie WD. Postoperative complications following surgery for rectal cancer. Ann Surg. 2010;251:807–18.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Biondi A, Grosso G, Mistretta A, Marventano S, Toscano C, Drago F, et al. Laparoscopic vs. open approach for colorectal cancer: evolution over time of minimal invasive surgery. BMC Surg. 2013;13(Suppl 2):S12.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Cadiere GB, Himpens J, Germay O, Izizaw R, Degueldre M, Vandromme J, et al. Feasibility of robotic laparoscopic surgery: 146 cases. World J Surg. 2001;25:1467–77.Google Scholar
  4. 4.
    Papanikolaou IG. Robotic surgery for colorectal cancer: systematic review of the literature. Surg Laparosc Endosc Percutan Tech. 2014;24:478–83.PubMedPubMedCentralGoogle Scholar
  5. 5.
    Neutzling CB, Lustosa SA, Proenca IM, da Silva EM, Matos D. Stapled versus handsewn methods for colorectal anastomosis surgery. Cochrane Database Syst Rev. 2012:CD003144.Google Scholar
  6. 6.
    Platell C, Barwood N, Dorfmann G, Makin G. The incidence of anastomotic leaks in patients undergoing colorectal surgery. Color Dis. 2007;9:71–9.CrossRefGoogle Scholar
  7. 7.
    Slim K, Vicaut E, Panis Y, Chipponi J. Meta-analysis of randomized clinical trials of colorectal surgery with or without mechanical bowel preparation. Br J Surg. 2004;91:1125–30.CrossRefPubMedGoogle Scholar
  8. 8.
    Law WI, Chu KW, Ho JW, Chan CW. Risk factors for anastomotic leakage after low anterior resection with total mesorectal excision. Am J Surg. 2000;179:92–6.CrossRefGoogle Scholar
  9. 9.
    Rullier E, Laurent C, Garrelon JL, Michel P, Saric J, Parneix M. Risk factors for anastomotic leakage after resection of rectal cancer. Br J Surg. 1998;85:355–8.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Huang CW, Yeh YS, WC S, Tsai HL, Choy TK, Huang MY, et al. Robotic surgery with high dissection and low ligation technique for consecutive patients with rectal cancer following preoperative concurrent chemoradiotherapy. Int J Color Dis. 2016;31:1169–77.CrossRefGoogle Scholar
  11. 11.
    Jafari MD, Lee KH, Halabi WJ, Mills SD, Carmichael JC, Stamos MJ, et al. The use of indocyanine green fluorescence to assess anastomotic perfusion during robotic assisted laparoscopic rectal surgery. Surg Endosc. 2013;27(8):3003.CrossRefPubMedGoogle Scholar
  12. 12.
    Kim HJ, Huh JW, Kim HR, Kim YJ. Oncologic impact of anastomotic leakage in rectal cancer surgery according to the use of fibrin glue: case-control study using propensity score matching method. Am J Surg. 2014;207(6):840.CrossRefPubMedGoogle Scholar
  13. 13.
    Yo LS, Consten EC, Quarles van Ufford HM, Gooszen HG, Gagner M. Buttressing of the staple line in gastrointestinal anastomoses: overview of new technology designed to reduce perioperative complications. Dig Surg. 2006;23:283–91.CrossRefPubMedGoogle Scholar
  14. 14.
    Vignali A, Gianotti L, Braga M, Radaelli G, Malvezzi L, Di Carlo V. Altered microperfusion at the rectal stump is predictive for rectal anastomotic leak. Dis Colon Rectum. 2000;43:76–82.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Chen CW, Chen MJ, Yeh YS, Tsai HL, Chang YT, Wang JY. Intraoperative anastomotic dye test significantly decreases incidence of anastomotic leaks in patients undergoing resection for rectal cancer. Tech Coloproctol. 2013;17:579–83.CrossRefPubMedGoogle Scholar
  16. 16.
    Yeh CY, Changchien CR, Wang JY, Chen JS, Chen HH, Chiang JM, et al. Pelvic drainage and other risk factors for leakage after elective anterior resection in rectal cancer patients: a prospective study of 978 patients. Ann Surg. 2005;241:9–13.PubMedPubMedCentralGoogle Scholar
  17. 17.
    Denost Q, Rouanet P, Faucheron JL, Panis Y, Meunier B, Cotte E, et al. To drain or not to drain infraperitoneal anastomosis after rectal excision for cancer: the GRECCAR 5 randomized trial. Ann Surg. 2017;265:474–80.CrossRefPubMedGoogle Scholar
  18. 18.
    Yin TC, Tsai HL, Yang PF, Su WC, Ma CJ, Huang CW, et al. Early closure of defunctioning stoma increases complications related to stoma closure after concurrent chemoradiotherapy and low anterior resection in patients with rectal cancer. World J Surg Oncol. 2017;15:80.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Luchtefeld MA, Milsom JW, Senagore A, Surrell JA, Mazier WP. Colorectal anastomotic stenosis. Results of a survey of the ASCRS membership. Dis Colon Rectum. 1989;32:733–6.CrossRefPubMedGoogle Scholar
  20. 20.
    MacRae HM, McLeod RS. Handsewn vs. stapled anastomoses in colon and rectal surgery: a meta-analysis. Dis Colon Rectum. 1998;41:180–9.CrossRefPubMedGoogle Scholar
  21. 21.
    Choy PY, Bissett IP, Docherty JG, Parry BR, Merrie AE. Stapled versus handsewn methods for ileocolic anastomoses. Cochrane Database Syst Rev. 2007:CD004320.Google Scholar
  22. 22.
    Bannura GC, Cumsille MA, Barrera AE, Contreras JP, Melo CL, Soto DC. Predictive factors of stenosis after stapled colorectal anastomosis: prospective analysis of 179 consecutive patients. World J Surg. 2004;28:921–5.CrossRefPubMedGoogle Scholar
  23. 23.
    Matthiessen P, Hansson L, Sjodahl R, Rutegard J. Anastomotic-vaginal fistula (AVF) after anterior resection of the rectum for cancer--occurrence and risk factors. Color Dis. 2010;12:351–7.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  1. 1.Kaohsiung Medical University and HospitalKaohsiungTaiwan

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