Akademik Veri Yönetim Sistemi
XX. Ulusal ve III. Uluslararası Türk Kolon ve Rektum Cerrahisi Kongresi, Antalya, Türkiye, 16 - 20 Mayıs 2025, ss.129, (Özet Bildiri)
Objective: Anastomosis techniques in rectal cancer surgery impact surgical outcomes and complications. Very Low Anterior Resection(VLAR) is commonly used for sphincter preservation, but when VLAR is not feasible, Transanal Transection with Single-Stapled Anastomosis(TTSS) may offer a safer alternative. This retrospective study compares the clinical outcomes and complication rates of VLAR and TTSS. Materials-Methods: This study includes 48 rectal cancer patients who underwent surgery between 2019-2025. Patients who had abdominoperineal resection(APR) or handsewn anastomosis were excluded. According to the Rullier classification, only type 1-2 tumors were included. Patients were categorized into two groups:VLAR or TTSS. Transection was performed using an instrument based on pelvic depth, and TTSS was applied when standard transection was not feasible. Results: The mean age of the patients was 62.4(28-96)years, and 29(60.4%) were male. The stage distribution was as follows:13(27%) patients were Stage I-II, 29(60%) were Stage III, and 6(13%) were Stage IV. 43(90%) patients received neoadjuvant chemoradiotherapy. Among the patients, 4(8%) underwent TTSS, while the remaining patients underwent VLAR. The mean operative time was 548 minutes in the TTSS group and 271 minutes in the VLAR group(p=0.002). The mean hospital stay was 8 days for TTSS patients and 12 days for VLAR patients, with no statistically significant difference(p=0.387). No patients in the TTSS group had a Clavien-Dindo score of 3b or higher, whereas 7(16%) in the VLAR group had scores of 3b or higher(p=0.4). No postoperative mortality was observed in any patient.No anastomotic leakage was detected in TTSS patients,3 VLAR patients experienced anastomotic leakage. Conclusion: Although TTSS requires a longer operative time, it has lower complication rates than VLAR, making it a viable alternative when VLAR is not feasible. Its ability to reduce severe complications and anastomotic leakage supports its use in select patients. Further studies are needed to validate these f indings and refine surgical strategies for distal rectal cancer. Keywords: Transanal Transection with Single-Stapled Anastomosis (TTSS), Distal Rectal Cancer Surgery