[Low anterior resection of the rectum with total mesorectal excision--immediate results].

AIM: this study was aimed at analyzing the immediate postoperative course in rectal cancer patients who underwent a low anterior resection of the rectum with total mesorectal excision.

MATERIAL AND METHODS: A retrospective study was carried out on a series of 75 patients operated between January 1, 2004 and December, 31 2010 at the 1lrd Surgical Unit of the Iasi "St. Spiridon" Hospital,. Low anterior resection of the rectum with total mesorectal excision was performed in all the patients. Data from medical files regarding the immediate postoperative course were analyzed.

RESULTS: Neoadjuvant therapy was instituted in 32 patients. There were 28 mechanical colorectal anastomoses and 47 manual anastomoses. Protective ileostomy was performed in 46 cases, including I manual anastomosis and 35 mechanical anastomosis cases. Anastomotic fistulas occured in II patients (6 with manual suture and 5 with stapler). Wound complications were identified in 5 cases, while retraction of ileostomy in 2. Two patients died from anastomotic fistula causing abdominal sepsis and multiple organ failure. In both cases ileostomy was performed at the reintervention, concomitantly with drainage of the abdominal abscesses.

CONCLUSIONS: Healing of the colorectal anastomosis remains the major problem with low anterior resection of the rectum. Protective ileostomy reduces the risk of serious complications in the event of anastomotic fistula.