High tie in anterior resection for rectal cancer confers no increased risk of anastomotic leakage

Commentor: Gunnar Arbman - Department of Surgery
Date: Jan 05, 2012

Author: M. Rutegård, O. Hemmingsson, P. Matthiessen, J. Rutegård

Reading Your Views is open to all but you must be registered on the site to submit your own Your Views.

If you have previously registered on the BJS site, simply login now using the link at the top of the page.

To register on the BJS site, simply click here.
It’s quick, easy, and free to do, so join in the discussion today!

Please note that Your Views are limited to 250 words.

Your Views

I read the paper with special interest as on the same day I operated on an old woman for rectal cancer. When I made the high tie, the left colon became ischaemic and the patient ended up with a transverse colostomy.

Maybe anastomotic leakage isn´t the main consequence if the marginal arterial circulation is insufficient, but rather gangrene of the left colon. This is either discovered peroperatively with resection of the bowel and the procedure might need to be converted to a Hartmann´s procedure or APR or postoperatively in which case the patient is has to return to theatre. Neither of these events will be classified as an anastomotic leakage in the Swedish rectal cancer registry, but reoperations are registered. Have the authors found any reoperations for gangrene of the left colon in the registry?