← Issue №6/ week of Aug 9, 2026/Colorectal

Short- and Long-term Outcomes of Three-Row Versus Two-Row Circular Staplers for Low Colorectal Anastomosis After Total Mesorectal Excision: A Single-Center, Randomized, Single-Blind, Phase III Trial (THREESTAPLER Study).

From GI Signals issue №6: what this paper found, what it changes, and where it sits against the current standard of care, reviewed by Simon Mathews, MD.

Colorectal rct · n=154 · Aug 10, 2026 · Dis Colon Rectum · IF 3.5

Short- and Long-term Outcomes of Three-Row Versus Two-Row Circular Staplers for Low Colorectal Anastomosis After Total Mesorectal Excision: A Single-Center, Randomized, Single-Blind, Phase III Trial (THREESTAPLER Study).

New evidencecolorectal surgery
Clinical takeawayNo change to current practice. Three-row staplers do not offer a leakage reduction advantage over established two-row technique; continue with two-row circular staplers for low anterior resection.
What it foundThree-row circular staplers did not reduce anastomotic leakage compared to two-row staplers (16.9% vs 15.6%, p=0.8); non-inferiority not established.
ContextAnastomotic leakage rates of 15-17% with both stapler types are consistent with current evidence. This negative non-inferiority trial does not support adopting three-row staplers as a technical improvement.
No standard claimed for this paper

Every paper is compared to the standard governing its question. This one is not: either no standard in the corpus matches it, or the comparison did not hold up on review and was withdrawn rather than published unverified. Both are logged.

Tulina I … Tsarkov P · Diseases of the Colon and Rectum · IF 3.5 · PubMed ↗Permalink
← Read the whole of issue №6 Every paper GI Signals surfaces gets a page like this one. All issues