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  • 1
    Electronic Resource
    Electronic Resource
    Healing of colonic anastomoses: Comparative experimental study of glued, manually sutured, and stapled anastomoses (1991)
    Springer
    Diseases of the colon & rectum 34 (1991), S. 557-562 
    Details
    ISSN: 1530-0358
    Keywords: Colonic anastomoses ; Fibrin glue ; Staples ; Sutures
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In 10 pigs a nonsutured, glued colonic anastomosis was constructed with a modified stapling device without staples and compared with an EEA-stapled anastomosis and a one-layer-sutured anastomosis concerning radiologic appearance, breaking strength, circulation, and collagen concentration.141Ce-labeled microspheres were used for measurements of the anastomotic blood flow before the animals were sacrificed on the 4th postoperative day. The breaking strength was recorded and an anastomotic index calculated. No leakage was found. The anastomotic width did not differ between the groups, but the interindividual variation was more prominent in the sutured group. The handsewn and stapled anastomoses were stronger than the glued anastomosis (P=0.0009 and 0.0054, respectively). There was an increase in the anastomotic circulation in all of the anastomoses, but no differences were seen between groups. The collagen concentration was independent of the technique used.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02049894
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  • 2
    Electronic Resource
    Electronic Resource
    Are intersecting staple lines a hazard in intestinal anastomosis? (1992)
    Springer
    Diseases of the colon & rectum 35 (1992), S. 892-896 
    Details
    ISSN: 1530-0358
    Keywords: Small bowel anastomosis ; Colonic anastomosis ; Stapling devices ; Microcirculation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To determine the safety of intersecting staple lines, 22 pigs were operated upon with a functional end-to-end enteroanastomosis 40 cm distal to the ligament of Treitz using linear stapling devices. The procedure was repeated on the colon, where a colocolostomy was created. The blood flow at intersecting staple lines and single-row staple lines for each anastomosis was studied with the reference organ method 24 hours after the first operation. The purpose was to evaluate whether there is a reduction in blood flow at the site of intersecting staple lines, causing an increased risk for anastomotic leakage. The reduction in mean blood flow in crossing compared with noncrossing staple lines was 6 percent (−5–17 percent) for small bowel anastomoses and 7 percent (−6–19 percent) for colonic anastomoses. An equivalence test showed that, if a reduction in blood flow exists between crossing and noncrossing staple lines, it is most likely less than 30 percent (P 〈0.001) for both small bowel and colonic anastomoses. This experimental study demonstrates that intersecting staple lines in small bowel and colonic anastomoses do not reduce anastomotic blood flow to a dangerous level.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02047879
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Anastomotic Diameters and Strictures following Esophagectomy and Total Gastrectomy in 256 Patients (2000)
    Springer
    World journal of surgery 24 (2000), S. 78-85 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The prevalence of anastomotic strictures in esophageal anastomoses provides us with limited information about the anastomotic healing process. This prospective study evaluates the exact esophageal anastomotic diameters in 256 patients who underwent esophagectomy and esophagogastrostomy without pyloroplasty (n= 107) or total gastrectomy and Roux reconstruction (n= 149). No perioperative chemoradiotherapy was given. Anastomotic strictures and diameters were assessed during endoscopy by a separately inserted (inflated to the anastomotic width) balloon catheter. The anastomotic diameters increased significantly during the first postoperative year in the esophagectomy (p= 0.001) and gastrectomy (p 〈 0.001) groups. The anastomoses in the gastrectomy group were significantly wider than those in the esophagectomy group 3 (25.7 versus 19.9 mm), 6 (28.5 versus 22.0 mm), and 12 (30.5 versus 23.3 mm) months after surgery (p 〈 0.001). Neither the anastomotic site (neck or chest) in the esophagectomy group (p= 0.176) nor that in the gastrectomy group (abdomen or chest) (p= 0.577) influenced the anastomotic diameter. Benign anastomotic strictures were most frequently found after 3 months and after esophagectomy. Esophagojejunostomies performed with 2 linear stapling devices or cartridge size 28 mm showed the widest anastomoses with only 1 stricture. Esophagogastric anastomoses following esophagectomy are narrower and develop more strictures than esophagojejunal anastomoses after total gastrectomy, but both dilate during the first year.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002689910015
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    Paper (German National Licenses)
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