Side-to-End Colorectal Anastomosis With Monofilament Stainless Steel Wire

Anastomotic separation after anterior resection of the rectum remains a major problem, although the frequency of anastomotic dehiscence after anterior resection varies. Monofilament stainless steel wire suture is an inert suture, has excellent holding power, and is associated with a low probability of wound infection. Side-to-end coloproctostomy for anastomotic reconstruction after anterior resection has proved to be a satisfactory alternative to the usual end-to-end anastomosis. A combination of wire suture with side-to-end coloproctostomy was performed in 60 consecutive anterior resections in which there were two clinical anastomotic leaks and no deaths attributable to anastomotic dehiscence. Simultaneous loop transverse colostomy was performed in 13 cases (22%), and all colostomies were subsequently closed without difficulty. This technique is recommended for reconstruction of bowel continuity after anterior resection of the rectum.