Anastomotic suture incompetence after transperitoneal resection of the rectum

Sphincter saving operations were made in 68.1% of 276 radical operations on the rectum, 85.6% of them being transperitoneal resections. The advantages of this operation are: less traumaticity, blood loss and postoperative lethality as well as saved function of the sphincter apparatus. Incompetence of the sigmorectal anastomosis sutures developed in 29 (18.6%) patients. The dependence of frequency of this complication on the sex and age of the patients, on the character of the disease and localization of tumor, on using suturing apparatuses, radiation treatment and unloading colostomy was studied. The distinctions found proved to be unreliable. Direct causes of the development of the complication are thought by the author to be technical defects of the surgery, disturbed blood supply and regenerative abilities of the sutured end of the gut. Recommendations are given how to prevent the development of the complication and of its more severe consequences.