Allaix, M

Mistrangelo, M

Morino, M.

Resegotti, A

English

Institutional Research Information System University of Turin

17 October 2023AperTO - Archivio Istituzionale Open Access dell'Università di TorinoOriginal Citation:Comment on: "Safety of Small Circular Staplers in Double Stapling Technique Anastomosis forSigmoid Colon and Rectal Surgery"Terms of use:Open Access(Article begins on next page)Anyone can freely access the full text of works made available as "Open Access". Works made availableunder a Creative Commons license can be used according to the terms and conditions of said license. Useof all other works requires consent of the right holder (author or publisher) if not exempted from copyrightprotection by the applicable law.Availability:This is the author's manuscriptThis version is available http://hdl.handle.net/2318/1835450 since 2022-10-17T10:32:38ZDownloadedfromhttp://journals.lww.com/dcrjournalbyBhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC1y0abggQZXdtwnfKZBYtws=on01/25/2022Downloadedfromhttp://journals.lww.com/dcrjournalbyBhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC1y0abggQZXdtwnfKZBYtws=on01/25/20221 Diseases of the Colon & Rectum Publish Ahead of Print DOI: 10.1097/DCR.0000000000002402 Comment on: “Safety of Small Circular Staplers in Double Stapling Technique Anastomosis for Sigmoid Colon and Rectal Surgery” Andrea Resegotti, M.D. Marco Allaix, M.D. Massimiliano Mistrangelo, M.D. Mario Morino, M.D., A.S.A. (Hon.), A.F.C. (Hon.) ACCEPTEDCopyright © The American Society of Colon & Rectal Surgeons, Inc. Unauthorized reproduction of this article is prohibited2  We read with great interest the paper by Nagaoka et al,1 showing the safety of using 25-mm circular staplers in the double stapling technique anastomosis. In 2016, we2 published a series of 37 patients who underwent restorative proctocolectomy with double-stapled ileal-pouch-anal anastomosis using 25-mm circular staplers. Functional results were good. Mean number of bowel movements was 4.5 during the day and 0.9 at night, 68% of patients were fully continent, and 32% had occasional soiling. No one reported incontinence: we ascribed those results to reduced sphincter injury and functional damage during transanal introduction of a smaller stapler. Additional advantages are a reduced risk of entrapment of the vagina during stapler closure and, in the double stapling technique, a reduced risk of disruption of the linear staple line when the circular stapler is introduced in a very short anal stump. That a smaller stapler could increase the risk of anastomotic stenosis is far from demonstrated; even if so, gentle digital dilatation in the office is usually effective, and it is straightforward in a very low anastomosis. So, we agree with Nagaoka et al about the advantages of small-diameter circular staplers; in our opinion, the 25-mm circular stapler should be the stapler of choice for ileal-pouch anal anastomosis.   ACCEPTEDCopyright © The American Society of Colon & Rectal Surgeons, Inc. Unauthorized reproduction of this article is prohibited3  References 1. Nagaoka T, Yamaguchi T, Nagasaki T, et al. Safety of small circular staplers in double stapling technique anastomosis for sigmoid colon and rectal cancer. Dis Colon Rectum. 2021;64:937–945. 2. Resegotti A, Silvestri S, Astegiano M, et al. “Small is beautiful” A series of ileo-anal anastomoses performed with the 25 - mm circular stapler. Ann Ital Chir. 2016;87:186–191.  ACCEPTEDCopyright © The American Society of Colon & Rectal Surgeons, Inc. Unauthorized reproduction of this article is prohibited

Comment on: "Safety of Small Circular Staplers in Double Stapling Technique Anastomosis for Sigmoid Colon and Rectal Surgery"

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Comment on: "Safety of Small Circular Staplers in Double Stapling Technique Anastomosis for Sigmoid Colon and Rectal Surgery"

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