AimTotal mesorectal excision with adequate free margins is the gold standard for rectal surgery. Applying a linear stapler in a narrow pelvis can be challenging and the proper distal margin difficult to assess. In selected cases the colorectal eversion technique combined with single‐stapled double‐purse‐string anastomosis (SSDP) can be a practical solution.MethodEleven patients, six men and five women, mean body mass index 27 ± 1.3 kg/m2, underwent total mesorectal excision with the colorectal eversion technique combined with modified SSDP between September 2022 and January 2023.ResultsThe mean operative time was 190 min. The mean hospital stay was 4 days. There were no postoperative complications. The final histology showed complete mesorectal resection, circumferential resection margin negative, free distal resection margin, anastomotic doughnuts negative. At 7 ± 3 months follow‐up there was no evidence of local recurrence or distant metastasis.ConclusionThe colorectal eversion technique combined with modified SSDP is a reproducible and safe technique in selected patients. Prospective randomized trials with large patient series are needed to confirm our preliminary results.

中文翻译：

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结直肠外翻技术联合改良单钉双荷包低位结直肠吻合术

目的 具有足够游离边缘的全直肠系膜切除术是直肠手术的金标准。在狭窄的骨盆中应用线性吻合器可能具有挑战性，并且难以评估适当的远端边缘。在某些情况下，结直肠外翻技术结合单钉双荷包吻合术 (SSDP) 可能是一种实用的解决方案。方法 11 名患者，其中 6 名男性和 5 名女性，平均体重指数 27 ± 1.3 kg/m22022年9月至2023年1月，采用结直肠外翻技术联合改良SSDP进行全直肠系膜切除术。结果平均手术时间为190分钟。平均住院时间为 4 天。无术后并发症。最终组织学显示直肠系膜完全切除，环周切除边缘阴性，游离远端切除边缘，吻合圈阴性。7±3个月的随访中，没有局部复发或远处转移的证据。结论结直肠外翻技术联合改良SSDP对于选定的患者来说是一种可重复且安全的技术。需要对大量患者进行前瞻性随机试验来证实我们的初步结果。