Influence of oversewing the transverse staple line during functional end‐to‐end stapled intestinal anastomoses in dogs

2020 ◽  
Vol 49 (6) ◽  
pp. 1221-1229
Author(s):  
Daniel J. Duffy ◽  
George E. Moore
Keyword(s):  
Staple Line ◽  
Intestinal Anastomoses ◽  
End To End

Intestinal Anastomosis

2015 ◽  
Author(s):  
Neil J. Mortensen ◽  
Shazad Ashraf
Keyword(s):  
Double Layer ◽  
Bowel Obstruction ◽  
Intestinal Anastomosis ◽  
Anastomotic Healing ◽  
Cancer Trial ◽  
Defunctioning Stoma ◽  
Intestinal Anastomoses ◽  
Increased Risk ◽  
Mechanical Bowel Obstruction ◽  
End To End

The creation of a join between two bowel ends is an operative procedure that is of central importance in the practice of a general surgeon. Leakage from an intestinal anastomosis can be disastrous, resulting in prolonged hospital stays and increased risk of mortality. To minimize the risk of potential complications, it is important to create a tension-free join with good apposition of the bowel edges in the presence of an excellent blood supply. This review discusses the factors that influence intestinal anastomotic healing, the various technical operations for creating anastomoses, and operative techniques currently used in constructing anastomoses. Tables review the principles of successful intestinal anastomosis, consequences of postoperative dehiscence, factors linked with dehiscence, anastomotic techniques ranked by best blood flow to the healing site, comparison of hand and stapled techniques, leak rates from the Rectal Cancer Trial on Defunctioning Stoma and the Contant and colleagues mechanical bowel obstruction trial, leak and wound infection rates from mechanical bowel obstruction meta-analyses, diseases and systemic factors associated with poor anastomotic healing, lifestyle-associated leakage rates, salvage after anastomotic leakage, standard checks for creation of anastomoses, and steps for left-sided stapled colorectal anastomoses for cancer. Figures show the phases of wound healing, the tissue layers of the jejunum, interrupted and continuous suture techniques, stitches commonly used in fashioning intestinal anastomoses, double-layer end-to-end anastomosis, traction sutures, anatomic relations between the colon and the retroperitoneal organs, single-layer sutured side-to-side enteroenterostomy, Finney strictureplasty, double-layer sutured end-to-side enterocolostomy, double-stapled end-to-end coloanal anastomosis, use of a “glove” port in laparoscopic surgery, and perfusion assessment at the time of anastomotic creation. This review contains 14 figures, 13 tables, and 85 references.

scholarly journals Staple-line recurrence arising 10 years after functional end-to-end anastomosis for colon cancer: a case report

2015 ◽  
Vol 1 (1) ◽  
Author(s):  
Akira Ouchi ◽  
Masahiko Asano ◽  
Keiya Aono ◽  
Tetsuya Watanabe ◽  
Shingo Oya
Keyword(s):  
Colon Cancer ◽  
Case Report ◽  
Staple Line ◽  
End To End

scholarly journals Single layer versus double layer intestinal anastomoses: a comparative study

2020 ◽  
Vol 7 (9) ◽  
pp. 2991
Author(s):  
Ajit Kumar ◽  
Vinod Kumar
Keyword(s):  
Comparative Study ◽  
Anastomotic Leak ◽  
Double Layer ◽  
Intestinal Anastomosis ◽  
Single Layer ◽  
Anastomosis Group ◽  
Layer Versus ◽  
Intestinal Anastomoses ◽  
Significant Difference ◽  
End To End

Background: There are still conflicting views regarding suitability of single layer and double layer anastomotic technique. This prospective single blinded randomized comparative study conducted at Rajendra Institute of Medical Sciences to assess various aspects viz. safety, efficacy, duration of hospital stays and chances of perforation in single- and double-layer anastomotic surgery.Methods: 26 patients each in single layer and double layer anastomosis group were included in the study.  Single layer intestinal anastomosis was carried using extramucosal technique with 2-0 vicryl suture (round body). Double layer anastomosis was carried out using interrupted 3-0 silk lembert sutures for the outer layer and a continuous 2-0 vicryl for the inner layer. End to end colocolic, end to end ileocolic, end to side ileocolic, end to end ileoileal, side to side ileoileal, end to end jejunoileal and end to end jejunojejunal anastomosis were performed. Each group was compared for anastomotic leak, time required to construct the anastomosis, cost incurred, and length of hospital stay.Results: Findings of the study indicated that single layer is economical in comparison to double layer anastomosis and took significant less time to operate. There was no significant difference in hospital stay of the patients in two groups. There was no anastomotic leak in group-S (single layer) while one (3.8%) patient in group-D (double layer) suffered from anastomotic leak.Conclusions: It was concluded that single layer anastomosis method is beneficial and safe as it required less operative time, suturing material and no leak took place after surgery.

scholarly journals Comparison of two end-to-end continuous sutures for intestinal anastomoses in dogs.

2021 ◽  
Author(s):  
CORNEL IGNA ◽  
ROXANA DASCALU ◽  
BOGDAN SICOE ◽  
CRISTIAN ZAHA ◽  
ILEANA BRUDIU ◽  
...  
Keyword(s):  
Intestinal Anastomosis ◽  
Intestinal Resection ◽  
Intestinal Lumen ◽  
Complication Rates ◽  
Continuous Suture ◽  
Intestinal Anastomoses ◽  
Equilibrium Angle ◽  
Anastomosis Site ◽  
End To End ◽  
Clinical Cases

Abstract Background: Single-layer appositional closures are preferred to inverting or everting patterns, as submucosal apposition has been shown to promote primary healing of the intestinal wall, whereas inverted or everted closures require second-intention healing and can increase the risk of luminal stenosis or anastomosis site leakage. There are different suture patterns available, but relatively few studies comparing these aspects have been published.The aim of this study was to compare two suture techniques for end-to-end anastomosis of the canine intestine (jejunum and colon): handsewn intestinal anastomosis by appositional simple continuous suture and inverting Cushing suture. The objectives of this study were to investigate 1.) whether the type of suture influences the specific effort to which the anastomosis site is submitted to, 2.) whether the anastomosis technique influences the diameter of the intestinal lumen and 3.) survival and complication rates in canine clinical cases undergoing end-to-end anastomoses. Results: The equilibrium angle for implanting the sutures in an anastomosis is 35°, aspect completely fulfilled by the simple continuous suture. The efforts to which sutures are submitted to in anastomoses are minimal for the Cushing suture. The difference in size of the anastomoses’ lumen between simple continuous suture and the Cushing suture are minimal, without being statistically relevant. The differences between the lumen of the anastomoses performed using PDS and those performed using PGA are not statistically relevant. The retrospective analysis of the outcome for 676 dogs (clinical cases) that underwent intestinal resection and anastomosis reveals that the dehiscence rate was 1.48%, out of which 1.18% following simple continuous anastomoses, and 0.3% following Cushing anastomoses. Narrowing of the intestinal lumen due to anastomotic healing was not registered.Conclusions: Use of the Cushing suture should be considered for performing an end-to-end intestinal anastomosis, although more studies are required to determine if there are any clinically significant differences between the sutures investigated in this study.

scholarly journals Sutureless functional end-to-end anastomosis using a linear stapler with polyglycolic acid felt for intestinal anastomoses

2017 ◽  
Vol 17 ◽  
pp. 50-53 ◽  
Author(s):  
Masanori Naito ◽  
Hirohisa Miura ◽  
Takatoshi Nakamura ◽  
Takeo Sato ◽  
Takahiro Yamanashi ◽  
...  
Keyword(s):  
Polyglycolic Acid ◽  
Linear Stapler ◽  
Intestinal Anastomoses ◽  
End To End

scholarly journals Risk Factors for Dehiscence of Stapled Functional End-to-End Intestinal Anastomoses in Dogs: 53 Cases (2001-2012)

2015 ◽  
Vol 45 (1) ◽  
pp. 91-99 ◽  
Author(s):  
Kyle A. Snowdon ◽  
Daniel D. Smeak ◽  
Sharon Chiang
Keyword(s):  
Risk Factors ◽  
Intestinal Anastomoses ◽  
End To End

Surgical management of extracranial carotid artery aneurysms

VASA ◽  
2016 ◽  
Vol 45 (3) ◽  
pp. 223-228 ◽  
Author(s):  
Jan Paweł Skóra ◽  
Jacek Kurcz ◽  
Krzysztof Korta ◽  
Przemysław Szyber ◽  
Tadeusz Andrzej Dorobisz ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Surgical Management ◽  
Minor Stroke ◽  
Stroke Rate ◽  
Extracranial Carotid Artery ◽  
Long Term Follow Up ◽  
End To End ◽  
Dacron Patch ◽  
Major Stroke

Abstract. Background: We present the methods and results of the surgical management of extracranial carotid artery aneurysms (ECCA). Postoperative complications including early and late neurological events were analysed. Correlation between reconstruction techniques and morphology of ECCA was assessed in this retrospective study. Patients and methods: In total, 32 reconstructions of ECCA were performed in 31 symptomatic patients with a mean age of 59.2 (range 33 - 84) years. The causes of ECCA were divided among atherosclerosis (n = 25; 78.1 %), previous carotid endarterectomy with Dacron patch (n = 4; 12.5 %), iatrogenic injury (n = 2; 6.3 %) and infection (n = 1; 3.1 %). In 23 cases, intervention consisted of carotid bypass. Aneurysmectomy with end-to-end suture was performed in 4 cases. Aneurysmal resection with patching was done in 2 cases and aneurysmorrhaphy without patching in another 2 cases. In 1 case, ligature of the internal carotid artery (ICA) was required. Results: Technical success defined as the preservation of ICA patency was achieved in 31 cases (96.9 %). There was one perioperative death due to major stroke (3.1 %). Two cases of minor stroke occurred in the 30-day observation period (6.3 %). Three patients had a transient hypoglossal nerve palsy that subsided spontaneously (9.4 %). At a mean long-term follow-up of 68 months, there were no major or minor ipsilateral strokes or surgery-related deaths reported. In all 30 surviving patients (96.9 %), long-term clinical outcomes were free from ipsilateral neurological symptoms. Conclusions: Open surgery is a relatively safe method in the therapy of ECCA. Surgical repair of ECCAs can be associated with an acceptable major stroke rate and moderate minor stroke rate. Complication-free long-term outcomes can be achieved in as many as 96.9 % of patients. Aneurysmectomy with end-to-end anastomosis or bypass surgery can be implemented during open repair of ECCA.

Reliability of the Mangled Extremity Severity Score in the Management of Peripheral Vascular Injuries in Children: A Retrospective Review

2020 ◽  
Author(s):  
Ahmed Mousa ◽  
Ossama M. Zakaria ◽  
Mai A. Elkalla ◽  
Lotfy A. Abdelsattar ◽  
Hamad Al-Game'a
Keyword(s):  
Severity Score ◽  
Vein Graft ◽  
Bypass Surgery ◽  
Age Groups ◽  
Vascular Injuries ◽  
Peripheral Vascular ◽  
Group Iii ◽  
Mangled Extremity ◽  
Group I ◽  
End To End

AbstractThis study was aimed to evaluate different management modalities for peripheral vascular trauma in children, with the aid of the Mangled Extremity Severity Score (MESS). A single-center retrospective analysis took place between 2010 and 2017 at University Hospitals, having emergencies and critical care centers. Different types of vascular repair were adopted by skillful vascular experts and highly trained pediatric surgeons. Patients were divided into three different age groups. Group I included those children between 5 and 10 years; group II involved pediatrics between 11 and 15 years; while children between 16 and 21 years participated in group III. We recruited 183 children with peripheral vascular injuries. They were 87% males and 13% females, with the mean age of 14.72 ± 04. Arteriorrhaphy was performed in 32%; end-to-end anastomosis and natural vein graft were adopted in 40.5 and 49%, respectively. On the other hand, 10.5% underwent bypass surgery. The age groups I and II are highly susceptible to penetrating trauma (p = 0.001), while patients with an extreme age (i.e., group III) are more susceptible to blunt injury (p = 0.001). The MESS has a significant correlation to both age groups I and II (p = 0.001). Vein patch angioplasty and end-to-end primary repair should be adopted as the main treatment options for the repair of extremity vascular injuries in children. Moreover, other treatment modalities, such as repair with autologous vein graft/bypass surgery, may be adopted whenever possible. They are cost-effective, reliable, and simple techniques with fewer postoperative complication, especially in poor/limited resources.

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