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The advantages of circular stapling devices include the possibility of anastomosing without a bougie and insufflation, reducing the overall time of an operation. We therefore evaluate whether an incisional bougie is still a necessary requirement for performing a rectal stapled anastomosis. The data are based on case notes of patients who have undergone a total colectomy and permanent end ileostomy between December 1997 and May 2001 (n = 61). Thirty-four patients underwent a circular stapled anastomosis alone, whereas 27 patients underwent the circular stapling anastomosis assisted by a bougie. The overall complications for the two groups were similar. The only significant difference was a higher rate of anastomotic leakage in patients who had undergone the circular stapling anastomosis without a bougie (4.5 vs. 0.0 per cent, P = 0.05). There was no difference in the length of hospital stay (11.1 vs. 12.3 days, P = 0.19) or recovery time (14.3 vs. 14.2 days, P = 0.79). In our experience, it is unnecessary to use an incisional bougie for performing a rectal stapled anastomosis without a faecal diverting ileostomy. In view of the small number of complications and the simplicity of using circular staplers, we therefore recommend that this option be strongly considered whenever possible in rectal surgery.WASHINGTON: US President Donald Trump spoke to the country’s top cop on Wednesday about the violence 0b46394aab