Local recurrence of rectal carcinoma after hand-sewn and stapled anastomoses

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Abstract
A retrospective analysis was conducted of 119 consecutive patients in whom potentially curative anterior resection of invasive rectal carcinoma was performed. Seventy-six anastomoses were stapled and 43 were had-sewn. The distributions of tumor stage, location, histologic grade, size and margins of resection were similar for both groups. The probability of local recurrence by 2 yr for middle rectal tumors was 26 .+-. 7% for the group with stapled anastomoses and 10 .+-. 7% for those with hand-sewn anastomoses (P = 0.07, log-rank test). Local recurrence probabilities did not differ for upper rectal tumors (P = 0.14) or lower rectal tumors (P = 0.20). Anatomic considerations that encourage use of the stapler may explain the findings.