Use of the end-to-end anastomosis stapling device in low colorectal anastomosis associated with radical gynecologic surgery

Between 1978 and 1984, 49 rectosigmoid anastomoses were performed using the end to end anastomosis (EEA) stapler. Seventeen (35%) of the patients had prior radiation treatment. Twenty-eight (57%) of the anastomoses were at the level of the peritoneal reflection and 21 (43%) were at the level of the levators. Fourteen patients (29%) had diverting colostomies and 11 (79%) of these were closed. There were 5 complications (10%) directly related to the anastomosis. These included two strictures, two anastomotic breakdowns, and one case of fecal incontinence after colostomy closure. All complications arose in patients with prior radiation treatment.