An innovative and convenient technique to reduce anastomotic leakage after double stapling anastomosis: laparoscopic demucositized suture the overlapping point of the “dog ear” area

Yi, Xiaojiang; Liao, Weilin; Feng, Xiaochuang; Li, Hongming; Chen, Zhaoyu; Wang, Jiahao; Lu, Xinquan; Wan, Jin; Lin, Jiaxin; Hong, Xiaoyan; Diao, Dechang

doi:10.1007/s13304-022-01282-w

Cited by 7 publications

(4 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The presented way of influencing the regeneration of a sutured wound of the bowel wall and other similar known ways [18][19][20][21][22][23][24]26,27] are aimed at optimizing regeneration processes. The advantage of such ways, including ours, over ways based on the modification of bowel sutures [3,15,16,20] is that the regression of inflammation is accelerated, and the formation of connective tissue is stimulated. The modification of the bowel sutures improves conditions for bowel wound healing but does not improve regeneration.…”

Section: Discussionmentioning

confidence: 99%

“…Main reasons of regeneration disorders are the presence of malignant neoplasms, comorbid diseases, bowel ischemia, bowel obstruction, acute intra-abdominal infections [1][2][3]8,9]. Various ways have been proposed for the prevention of sutures leakage, such as the use of intestinal tubes [10,11], preventive stomas [12,13], modification of the suture application technique [3,[14][15][16], sutures strengthening [17][18][19]. However, their effectiveness does not meet the urgent needs [20,21].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Possibilities of local effect the healing of small bowel sutures in a rat model of acute intra-abdominal infection

2024

FEM

View full text Add to dashboard Cite

Aims: Investigate the regeneration of the small bowel suture line regeneration after suturing with a material with antioxidant properties. Methodology: 7 intact rats, 63 with simulated intra-abdominal infection (IAI). A laparotomy was performed in 12 h after simulating. The small bowel was cut and sutured in 56 rats (2 groups of 28) after an abdominal lavage. Standard Kapron was used in the control group (CG). Kapron impregnated with a 5% solution of ethylmethylhydroxypyridine succinate was used in the research group (RG). Sections of the small bowel were collected from a total of 21 rats (7 intact rats, 7 rats with intra-abdominal infection (IAI) models, and 7 rats at different time points (1, 3, 5, and 7 days) post suturing) for subsequent histological examination. The preparations were stained with hematoxylin-eosin and by Mikel Calvo. The R/B coefficient (R/BC) was determined. The experiment's time duration was 7.5 days in December 2022. Results: R/BC increased (p<0.05) in the connective tissue fibers of the small bowel submucosal base in 12 h after the simulating of IAI. R/BC increased (p<0.05) in both groups in 1 day after suturing. R/BC increased in CG, decreased (p<0.05) in RG in 3 days. Fibrin was found between the ligature’s fibers in RG. R/BC decreased (p<0.05) in both groups in 5 days, indicators were smaller (p<0.01) in RG. Fibrin was found between the ligature’s fibers in CG, granulation tissue was in RG. R/BC decreased in both groups in 7 days, but indicators were smaller in RG (p<0.01). Unfilled areas in the granulation tissue between the ligature fibers were in CG. Conclusion: 1. The use of ligatures impregnated with the 5% ethylmethylhydroxypyridine succinate solution for suturing the small bowel in rats with intra-abdominal infection models is associated with the significant decrease in the activity of local proteins oxidation and the significant acceleration of local regeneration processes. 2. The creation of a suture material with antioxidant properties may be a promising direction for the prevention of suture leakage

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Possibilities of local effect the healing of small bowel sutures in a rat model of acute intra-abdominal infection

2024

FEM

View full text Add to dashboard Cite

show abstract

“…Protective stoma is a conventional strategy to prevent AL, but its efficacy remains controversial. A meta-analysis showed that protective stoma can reduce the incidence of AL, but the evidence is weak, and routine preventive stoma for rectal cancer requires high-quality evidence ( 21 ), and stoma-related complications can occur ( 21 , 22 ). Transanal decompression tubes are also widely used to prevent AL.…”

Section: Discussionmentioning

confidence: 99%

Novel surgical procedure for preventing anastomotic leakage following colorectal cancer surgery: A propensity score matching study

Tang

Zhang

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

Hypoperfusion is the main cause of anastomotic leakage (AL) following colorectal surgery. The conventional method for evaluating anastomotic perfusion is to observe color change and active bleeding of the resection margin of the intestine and the pulsation of mesenteric vessels. However, the accuracy of this method is low, which may be due to insufficient observation time. A novel surgical procedure that separates the mesentery in advance at the intended transection site can delay the observation of anastomotic perfusion, and can potentially detect more anastomotic sites with insufficient vascular supply and reduce the rate of AL. This study aimed to investigate the effects of a novel surgical procedure on AL following sigmoid colon and rectal cancer surgeries. A total of 343 patients who underwent rectal and sigmoid colon cancer surgeries were included in the study. From August 2021 to June 2022, patients with sigmoid colon or rectal cancer underwent a new surgical procedure of pre-division of the mesentery (PDM) at the intended transection site (PDM group). Patients with colorectal cancer who underwent conventional surgical procedures from August 2018 to July 2021 were categorized as the non-PDM group. Symptomatic AL (SAL) within 30 days and other outcomes were retrospectively analyzed using propensity score matching and compared between the two groups. The incidences of SAL were 1.3% and 11.3% in the PDM and non-PDM groups, respectively. PDM significantly reduced the SAL rate in sigmoid colon and rectal cancer surgeries (P = 0.009). The incidence of total postoperative complications (P < 0.05) was significantly lower in the PDM group than that in the non-PDM group. There were no significant differences between the two groups for operative time (P = 0.662), intraoperative blood loss (P = 0.651), intraoperative blood transfusion (P = 0.316), and intensive care rate (P = 1). The length of postoperative hospital stay (P = 0.010) and first exhaust (P = 0.001) and defecation time (P < 0.05) were shorter in the PDM group than in the non-PDM group. PDM can effectively prevent AL, and this procedure can be safely performed in sigmoid colon and rectal cancer surgeries.

show abstract

“…Transanal TME (TaTME) was recently developed to overcome these difficulties through enhanced visualization of the dissection plane and manoeuvrability in the deep pelvis 3 . In addition, anastomotic techniques after TaTME, known as double purse-string circular stapled anastomosis or single-stapling technique (SST), are expected to reduce anastomotic failure 4 as multiple stapler firing 5–7 or dog ear formation 8 , 9 does not occur, whereas this is more common in other approaches for tumours involving the lower third of the rectum, within 5–6 cm from the anal verge (AV) 10 . Although abdominoperineal resection is conventionally performed in low rectal cancer cases 11 , permanent colostomy could result in poor quality of life (QoL).…”

Section: Introductionmentioning

confidence: 99%

Single-stapling technique versus hand-sewn anastomosis in inter-sphincteric resection with transanal total mesorectal excision (Super SST): protocol for a multicentre randomized clinical trial

et al. 2023

View full text Add to dashboard Cite

Background Currently, hand-sewn anastomosis is the standard procedure for inter-sphincteric resection (ISR); however, distal purse-string suturing during transanal total mesorectal excision (TaTME) has allowed a single-stapling technique (SST). Although it was originally intended for cases requiring anastomosis of 2 cm or more above the anorectal junction (ARJ), SST could be safely performed in ISR. The aim of this trial is to determine the superiority of SST over hand-sewn anastomosis in ISR with TaTME. Methods The Super SST trial is a multicentre randomized clinical trial comparing stapled and hand-sewn anastomoses in ISR with TaTME. The trial will recruit patients scheduled for TaTME with anastomosis below the ARJ, who will be allocated 1:1 to receive either hand-sewn or stapled anastomosis. The primary endpoint is anastomosis-related complications within 30 postoperative days. Secondary endpoints include all early and late complications, operating time, reoperation, mortality rate, length of postoperative hospital stay, readmission, incidence of anal pain and rectal mucosal prolapse, length of temporary stoma retention, the proportion of patients with a temporary stoma at 1 year after surgery, and anorectal function at 1 year after surgery. Conclusion This trial will provide important clinical insights for new and promising anastomotic options for patients with very low rectal cancer. Registration number: UMIN000047818 (https://www.umin.ac.jp/ctr/index-j.htme).

show abstract

An innovative and convenient technique to reduce anastomotic leakage after double stapling anastomosis: laparoscopic demucositized suture the overlapping point of the “dog ear” area

Cited by 7 publications

References 48 publications

Possibilities of local effect the healing of small bowel sutures in a rat model of acute intra-abdominal infection

Possibilities of local effect the healing of small bowel sutures in a rat model of acute intra-abdominal infection

Novel surgical procedure for preventing anastomotic leakage following colorectal cancer surgery: A propensity score matching study

Single-stapling technique versus hand-sewn anastomosis in inter-sphincteric resection with transanal total mesorectal excision (Super SST): protocol for a multicentre randomized clinical trial

Contact Info

Product

Resources

About