Colocolostomy and coloproctostomy utilizing the circular intraluminal stapling devices

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Abstract
Coloproctostomy or colocolostomy by preanal insertion of a circular staping device was performed on 265 patients between Jan. 1978 and June 1981. A low anterior resection was performed in 174 patients. Stapler-related technical complications occurred in 52 patients (20%). Complementary transverse colostomies were performed in 11 patients, of which 7 were performed on the first 30 patients. Intraoperative complications occurred in 18 patients (7%). Twenty-six major postoperative complications occurred (10%) and clinical anastomotic leaks occurred in 8 patinets (3%). Four postoperative deaths occurred (1.5%). Evidently, coloproctostomy or colocolostomy can be safely performed by transanal insertion of a circular stapling device; these instruments allow a sphincter-preserving procedure to be performed for lesions in the low and midrectum (5-10 cm from the anal verge) with an acceptable early morbidity and mortality, and the majority of stapler-related technical complications can be managed without protecting colostomy.