Prevention and management of pure-NOTES transanal total mesorectal excision for rectal cancer with postoperative anastomotic complications

Abstract

Objective To investigate the the preventive and management methods of pure-NOTES transanal total mesorectal excision (pure-NOTES TaTME) with postoperative anastomotic complications. Methods Retrospectively analyzed the clinical data of 59 cases with low and middle rectal cancer who were underment pure-NOTES TaTME in Linzi District People′s Hospital, and discussed the situction of the complications. Results Postoperative anastomotic complications were occurred in 3 cases, anastomotic leakage in 1 case, anastomotic stenosis in 1 case, anastomotic stenosis and leakage in 1 case, accounting for 5.1%. Conclusions For suitable rectal neoplasms patients, pure-NOTES TaTME operation doesn′t increase the incidence of anastomotic complication, and it′s is safe and feasible. Preoperative preparation, good blood supply, tension-free anastomosis, and correct choice and using of stapler and anastomotic drainage tube are the key to reduce anastomotic complications. Key words: Rectal neoplasms; Postoperative complications; Surgical stomas; Anastomotic leak; Anastomotic stenosis; Anastomotic bleeing