BACKGROUND: We compared triangulating anastomosis (TRI) with functional end-to-end anastomosis (FEEA) in terms of patient demographics, clinicopathological features, and short- and long-term outcomes in this study.
METHODS: From November 2005 to May 2016, 315 patients with transverse colon cancer underwent laparoscopic resection. TRI was performed in 62 patients and FEEA in 253 patients. Patients with another concomitant cancer, who received neoadjuvant chemotherapy, and/or who underwent another operation at the same time were excluded.
RESULTS: The patients\' backgrounds were comparable in each group. Transverse colectomy was selected more frequently in TRI and right hemicolectomy in FEEA. The operation time was shorter in TRI. The rate of anastomotic leakage was comparable (1.6% in TRI vs. 0.8% in FEEA). Stricture was more common in TRI (8.1% vs. 0%) and bleeding was more common in FEEA (1.6% vs. 10.6%). The rate of long-term complications was comparable in each group. Overall survival of stage 0-III patients was comparable in each group (94.7% in TRI vs. 93.7% in FEEA). 5-year disease-free survival of stage 0-III, stage II, and stage III patients was also comparable in each group (94.8% vs. 93.0%, 100% vs. 92.1%, and 80.3% vs. 79.2% in TRI and FEEA, respectively).
CONCLUSIONS: The short- and long-term outcome rates were acceptable in both groups. Specific attempts to prevent complications are required for each anastomotic procedure.

OBJECTIVE: Advances in stapling devices have led to their widespread use in colorectal surgery. We compared the strength of four types of anastomoses using bursting pressure.
METHODS: We created stapled anastomosis models [double stapling technique (DST), functional end-to-end anastomosis (FEEA) unbuttressed or buttressed, and triangulating anastomosis (TA) with two- or three-row stapling] and a hand-sewn anastomosis model. Bursting pressures of each method were measured. The primary end point was the bursting pressure. The effectiveness of buttressing and three-row stapling were the secondary endpoints.
RESULTS: The DST group had significantly lower bursting pressure than TA with three-row stapling, FEEA buttressed, and hand-sewn groups. No significant difference was found between the bursting pressure of the FEEA unbuttressed and FEEA buttressed groups and that of the TA with two-row and three-row stapling groups.
CONCLUSIONS: DST has the lowest bursting pressure compared to other anastomotic techniques. Buttressing suture and three-row stapling have no effect on the strength of anastomosis.

In colon surgery, the anastomotic method is generally selected by surgeon\'s preferences or by local conditions. In this study, we retrospectively analyzed anastomotic complications to assess safe methods of anastomosis in colonic resection.
We retrospectively analyzed a total of 684 cases, performed between July 2003 and June 2013 in our Hospital. Anastomosis complications, such as leakage, stricture and bleeding, were analyzed in relation to the three methods of anastomosis, hand-sewn (HS), functional end-to-end (FEEA) and triangulating anastomosis (TRI).
Univariate analysis indicated that the incidence of leakage was significantly lower in laparoscopic surgeries (p=0.034) and TRI (p=0.047). The results of the multivariable analysis indicated that anastomotic leakage was significantly less with TRI (p=0.029).
In colon surgery, TRI seems to be associated with a low risk of anastomotic leakage compared to HS and FEEA.