To the Editor.—I read with interest the article by Dr Frank J. Lepreau in the December 1978 issue of the Archives (113:1479), relating his experience with one case of low anterior resection with staples.
There is currently no reasonable information available that would substantiate Dr Lepreau's claim that a low anterior anastomosis is considerably simplified or more secure, or that the staples provide a cost-effective mode of putting bowel back together. We are currently involved in a randomized prospective study utilizing the stapler and have performed over 50 low anterior anastomoses with this device. Our experience suggests that although the instrument seems to have certain specific technical advantages, it certainly is not a panacea. This instrument should not be regarded as the most cost-effective way to reanastomize bowel. It seems inappropriate to me to present the instrument in this light with so little information available.