{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T04:18:16Z","timestamp":1781929096836,"version":"3.54.5"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,2,10]],"date-time":"2022-02-10T00:00:00Z","timestamp":1644451200000},"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":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>After total mesorectal excision (TME) for low rectal cancer, current guideline recommendations for sphincter\u2010saving surgery are to perform a side\u2010to\u2010end manual coloanal anastomosis (CAA) (or with J\u2010pouch) with a temporary stoma. Our study aimed to evaluate if delayed pull\u2010through coloanal anastomosis (DCAA) without a temporary stoma could represent a safe alternative in low rectal cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>From 2003 to 2020, 223 consecutive patients with low rectal cancer undergoing TME were compared: CAA and diverting stoma (<jats:italic>n<\/jats:italic>\u00a0=\u00a0190) versus DCAA without stoma (<jats:italic>n<\/jats:italic>\u00a0=\u00a033).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall 3\u2010month and severe (Dindo \u2265 IIIb) morbidity rates were similar in CAA versus DCAA groups: 34% (65\/190) vs. 36% (12\/33) and 2.6% (5\/190) vs. 3% (1\/33), respectively. In the DCAA group, only one patient (3%) underwent reoperation (Hartmann's procedure) at day 3 due to colon necrosis. The anastomotic leakage rate (both clinical and radiological) was significantly higher after CAA than DCAA: 28% (53\/190) vs. 3% (1\/33; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.00138). Failure of the procedure (with return to stoma) was observed in 8% (15\/190) vs. 6% (2\/33) of patients after CAA and DCAA respectively (not significant).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our comparative study suggested that in patients with low rectal cancer, DCAA without a temporary stoma could represent an interesting alternative to the actual recommended CAA with a temporary ileostomy. DCAA could offer two major advantages over CAA: a significantly lower rate of anastomotic leakage and absence of a temporary stoma and its potential complications (rehospitalization, dehydration, wound hernia after stoma closure).<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.16069","type":"journal-article","created":{"date-parts":[[2022,1,30]],"date-time":"2022-01-30T01:28:50Z","timestamp":1643506130000},"page":"587-593","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Delayed pull\u2010through coloanal anastomosis without temporary stoma: an alternative to the standard manual side\u2010to\u2010end coloanal anastomosis with temporary stoma? A comparative study in 223 patients with low rectal cancer"],"prefix":"10.1111","volume":"24","author":[{"given":"Dan","family":"Melka","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery DMU DIGEST Beaujon Hospital Assistance Publique\u2010H\u00f4pitaux de Paris (AP\u2010HP) University of Paris  Clichy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elsa","family":"Leiritz","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery DMU DIGEST Beaujon Hospital Assistance Publique\u2010H\u00f4pitaux de Paris (AP\u2010HP) University of Paris  Clichy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cam\u00e9lia","family":"Labiad","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery DMU DIGEST Beaujon Hospital Assistance Publique\u2010H\u00f4pitaux de Paris (AP\u2010HP) University of Paris  Clichy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Blondeau","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery DMU DIGEST Beaujon Hospital Assistance Publique\u2010H\u00f4pitaux de Paris (AP\u2010HP) University of Paris  Clichy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7434-1797","authenticated-orcid":false,"given":"Alice","family":"Frontali","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery DMU DIGEST Beaujon Hospital Assistance Publique\u2010H\u00f4pitaux de Paris (AP\u2010HP) University of Paris  Clichy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Giacca","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery DMU DIGEST Beaujon Hospital Assistance Publique\u2010H\u00f4pitaux de Paris (AP\u2010HP) University of Paris  Clichy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Monsinjon","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery DMU DIGEST Beaujon Hospital Assistance Publique\u2010H\u00f4pitaux de Paris (AP\u2010HP) University of Paris  Clichy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9553-9727","authenticated-orcid":false,"given":"Yves","family":"Panis","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery DMU DIGEST Beaujon Hospital Assistance Publique\u2010H\u00f4pitaux de Paris (AP\u2010HP) University of Paris  Clichy France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,2,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800730222"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800730223"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1950.01250020146016"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000018747"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003249"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003057"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9782"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e31828cb66c"},{"key":"e_1_2_10_10_1","unstructured":"CotteE ArtruP ChristouN ConroyT DoyenJ FabreJ et al. \u202fCancer du rectum\u202f. 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