Reducing AL After Double-Stapling Anastomosis: A Novel Laparoscopic Technique for Dog Ear Area Resection.

[PURPOSE] This study evaluates the effectiveness of laparoscopic dog ear region removal as a modified double-stapling anastomosis (DSA) technique to reduce the risk of anastomotic leakage (AL) after colorectal cancer surgery.

[METHODS] We retrospectively analyzed 216 colorectal cancer patients who underwent laparoscopic anterior resection between January 2022 and June 2024. Patients were divided into two groups: the non-dog ear group (n = 104), which underwent dog ear area resection before DSA, and the DSA group (n = 112), which received conventional treatment.

[RESULTS] Baseline demographics, comorbidities, tumor characteristics, and preoperative treatments were comparable between the two groups (all p > 0.05). There were no significant differences in operative time (non-dog ear: 213.57 ± 57.06 min vs. DSA: 210.23 ± 65.11 min, p = 0.688) or overall complication rates (9.62% vs. 17.85%, p = 0.080). However, the non-dog ear group had significantly lower AL incidence (1.92% vs. 8.04%, p = 0.041) and shorter postoperative hospitalization and drainage tube removal times.

[CONCLUSIONS] In this retrospective study, laparoscopic "dog ear" resection before DSA was associated with reduced AL risk and did not compromise surgical safety in colorectal cancer surgery, suggesting it may be a feasible refinement to standard procedures. These associations, however, require validation through prospective studies.