End-To-End versus Side-To-End Colorectal Anastomosis for Laparoscopic Low Anterior Resection; a Prospective Comparative Study

Background: The increasing emphasis on sphincter-preserving procedures for rectal pathology has led to advancements in surgical techniques, including trans-anal complete mesorectal excision, low anterior resection (LAR), and ultra-low anterior resection. These innovations, supported by technological developments in surgical instruments, facilitate improved visualization and mobilization during rectal surgeries, allowing better adherence to surgical standards.*Aim of the Work:* This study aims to compare the postoperative outcomes and complications associated with end-to-end versus side-to-end colorectal anastomosis in patients undergoing laparoscopic low anterior resection.Patients and Methods: A prospective comparative study was conducted involving 40 patients diagnosed with low rectal cancer at Ain-Shams University hospitals. Participants were divided into two groups: Group A (23 patients) underwent laparoscopic low anterior resection with end-to-end colorectal anastomosis, while Group B (17 patients) underwent side-to-end colorectal anastomosis.Results: The study found that Group A exhibited significantly shorter anastomotic and operative times compared to Group B (P < 0.001). Additionally, Group A reported significantly higher urgency of defecation at 12 months post-surgery compared to Group B (P=0.018). However, all other comparative measures yielded statistically insignificant results.Conclusion: The findings suggest that both surgical techniques yield comparable outcomes, with Group A demonstrating faster operation times but a slight increase in long-term urgency of defecation. Conversely, Group B may offer better functional outcomes despite a longer operation duration. These results underscore the need for personalized surgical approaches based on patient needs and preferences.