End-to-End Anastomosis with Omega Suture Versus End to Anterior Rectal Wall in Colorectal Anastomosis in sigmoid and upper rectal cancer, a prospective competitive study

Abstract

Background: Anastomotic techniques in colorectal surgery significantly influence postoperative complications, especially anastomotic leakage. This research contrasts two single-stapling methods: end-to-anterior rectal wall anastomosis and omega suture-based end-to-end anastomosis.

Aim: This study aims to compare the postoperative outcomes and complications associated with end-to-end with omega suture versus end to anterior rectal wall colorectal anastomosis in patients undergoing laparoscopic anterior resection in sigmoid and upper rectum cancer.

Patients and Methods: A prospective comparative study was conducted involving 40 patients diagnosed with sigmoid and upper rectal cancer at Ain Shams University hospitals. Participants were divided into two groups: group A (20 patients) underwent laparoscopic anterior resection with end-to-end with omega suture colorectal anastomosis, while group B (20 patients) underwent end to anterior rectal wall colorectal anastomosis.

Results: Group A demonstrated significantly longer anastomotic and total operative times compared to Group B (P < 0.001) and significant early postoperative bowel recovery (p=0.02). At 3 and 6 months postoperatively, Group A exhibited a statistically significant reduction in the frequency and urgency of defecation relative to Group B (P = 0.04) however, this difference was not maintained at 12 months, where no significant difference was observed. All other comparative parameters, including postoperative complications and long-term functional outcomes, were comparable between groups and did not reach statistical significance.

Conclusion: Both single-stapled anastomotic techniques—end-to-end anastomosis with omega suture (Group A) and end-to-anterior rectal wall anastomosis (Group B) are safe and effective with comparable post-operative finding.