Background: To explore the safety and efficacy of individualized choice regarding the method for ensuring negative margins in an anus-preserving operation for ultralow rectal carcinoma.
Methods: Thirty-seven patients with ultralow rectal carcinomas were enrolled from February 2011 to February 2013. On the premise of ensuring negative margins, 15 patients underwent a transabdominal coloanal anastomosis using a double-stapling technique; 12 patients underwent a transabdominal coloanal anastomosis using a triple-stapling technique; 7 patients underwent a transanal pull-through coloanal anastomosis using a double-stapling technique; and 3 patients underwent a transanal pullthrough coloanal anastomosis using a triple-stapling technique. Of the patients who underwent a transabdominal coloanal anastomosis, 8 patients had a preventive colostomy, and all patients who had a pull-through coloanal anastomosis had a preventive colostomy.
Results: Among the patients who did not have a preventive colostomy, 4 patients had an anastomotic fistula, and 1 patient had an anastomotic fistula with a hemorrhage and urination disorder. Additionally, 9 patients had short-term postoperative fecal incontinence; all had diarrhea, with symptom resolution 6 months later. The patients who had a preventive colostomy underwent diaplases 3 months later, with no deaths occurring.