{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T15:49:47Z","timestamp":1778860187251,"version":"3.51.4"},"reference-count":28,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2015,11,7]],"date-time":"2015-11-07T00:00:00Z","timestamp":1446854400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>This study compared the operative outcome and long\u2010term survival of three types of hand\u2010sewn coloanal anastomosis (CAA) for low rectal cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Patients presenting with low rectal cancer at a single centre between 2006 and 2014 were classified into three types of hand\u2010sewn CAA: type 1 (<jats:italic>supra<\/jats:italic>\u2010anal tumours undergoing transabdominal division of the rectum with transanal mucosectomy); type 2 (juxta\u2010anal tumours, undergoing partial intersphincteric resection); and type 3 (intra\u2010anal tumours, undergoing near\u2010total intersphincteric resection with transanal mesorectal excision).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy\u2010one patients with low rectal cancer underwent CAA: 17 type 1; 39 type 2; and 15 type 3. The median age of patients was 61.6\u00a0years, with a male\/female ratio of 2:1. Neoadjuvant therapy was given to 56 (79%) patients. R0 resection was achieved in 69 (97.2%) patients. Adverse events occurred in 25 (35.2%) of the 71 patients with a higher complication rate in type 1 <jats:italic>vs<\/jats:italic> type 2 <jats:italic>vs<\/jats:italic> type 3 (47.1% <jats:italic>vs<\/jats:italic> 38.5% <jats:italic>vs<\/jats:italic> 13.3%, respectively; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.035). Anastomotic separation was identified in six (8.5%) patients and pelvic haematoma\/seroma in five (7%); two (8.3%) female patients developed a recto\u2013vaginal fistula. Ten (14.1%) patients were indefinitely diverted, with a trend towards higher long\u2010term anastomotic failure in type 1 <jats:italic>vs<\/jats:italic> type 2 <jats:italic>vs<\/jats:italic> type 3 (17.6% <jats:italic>vs<\/jats:italic> 15.5% <jats:italic>vs<\/jats:italic> 6.7%). The type of anastomosis did not influence the overall or disease\u2010free survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>CAA is a safe technique in which anorectal continuity can be preserved either as a primary restorative option in elective cases of low rectal cancer or as a salvage procedure following a failed stapled anastomosis with a less successful outcome in the latter. CAA has acceptable morbidity with good long\u2010term survival in carefully selected patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.13028","type":"journal-article","created":{"date-parts":[[2015,6,19]],"date-time":"2015-06-19T16:54:36Z","timestamp":1434732876000},"page":"1062-1070","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Hand\u2010sewn coloanal anastomosis for low rectal cancer: technique and long\u2010term outcome"],"prefix":"10.1111","volume":"17","author":[{"given":"P.","family":"Tekkis","sequence":"first","affiliation":[{"name":"Department of Surgery and Cancer Imperial College London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Surgery and Cancer Imperial College London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Kontovounisios","sequence":"additional","affiliation":[{"name":"Colorectal The Royal Marsden Hospital London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Kinross","sequence":"additional","affiliation":[{"name":"Colorectal The Royal Marsden Hospital London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Georgiou","sequence":"additional","affiliation":[{"name":"Colorectal The Royal Marsden Hospital London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. 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