Results of surgery for cancer of the rectum with sphincter conservation. A randomized study on instrumental versus manual anastomosis

Abstract

We present results obtained in a group of patients included in a randomized study from 1979 to 1985 for evaluation of mechanical anastomosis after anterior resection for cancer of the rectum; 113 patients were operated on, 58 with manual and 55 with instrumental anastomosis. There was no significant difference in morbidity or mortality between the groups. The incidence of anastomotic fistulas (clinical and subclinical) was similar (12% vs. 15%), although a large number of tumors in the lower third of rectum was treated by manual anastomosis. Concerning late complications, more stenoses, although mainly asymptomatic, were detected after instrumental anastomosis (15% vs. 6%). The incidence of local recurrence within 3 years was quite similar in the 2 groups (about 15%), and usually occurred in patients who already had generalized disease.