Ex vivo comparison of hand-sutured versus circular stapled anastomosis in canine large intestine.
Journal
Veterinary surgery : VS
ISSN: 1532-950X
Titre abrégé: Vet Surg
Pays: United States
ID NLM: 8113214
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
revised:
29
06
2021
received:
31
01
2021
accepted:
25
07
2021
pubmed:
7
8
2021
medline:
26
11
2021
entrez:
6
8
2021
Statut:
ppublish
Résumé
To compare leakage pressures of colonic anastomoses performed with circular staplers to conventional hand-sewn techniques in dogs. Ex-vivo study. Colon from 11 canine cadavers. Thirty-two colonic anastomoses were performed. Four segments from each colon were randomly assigned to one of four techniques: hand-sewn colonic anastomoses performed with 4-0 glycomer 631 (G) and 4-0 barbed glycomer 631 (BG), and circular stapled colonic anastomoses using 4.8 mm End-to-End Anastomosis (EEA C4.8mm) and 3.5 mm End-to-End Anastomosis (EEA C3.5mm), 21 mm diameter circular staples in cadaveric canine colon. Leakage pressure was defined as the pressure at which dye-containing solution was first observed to leak from the anastomosis site. Leakage pressures were 49.5 mmHg (range:16-72) in group G, 45.5 mmHg (range:19-80) in group BG, 5.3 mmHg (range:0-31) in group C3.5mm, and 29.5 mmHg (range:23-50.3) in group C4.8mm. Anastomoses leaked at lower pressures when stapled rather than hand-sewn (C4.8mm-G p = .0313, C4.8mm-BG p = .0131, C3.5mm-G p = .0469, C3.5mm-BG p = .0313). Two of the C3.5mm constructs leaked immediately after saline infusion with 4/6 leaking at <5.3 mmHg. End-to-end colonic anastomoses closed with circular stapler leaked at lower pressures than hand-sutured anastomoses. Use of the EEA stapler with a staple height of 3.5 mm did not result in safe colonic anastomoses. These results provide evidence to support hand-suturing colonic anatomoses with G and BG in dogs. The 4.8 mm staples may be considered in anatomical locations difficult to reach.
Types de publication
Journal Article
Randomized Controlled Trial, Veterinary
Langues
eng
Sous-ensembles de citation
IM
Pagination
1495-1501Informations de copyright
© 2021 American College of Veterinary Surgeons.
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