An Intraluminal Prothesis may Improve Healing of a One-layer Colonic Anastomosis: An Experimental Study in Pigs

Buch, Niels; Glad, Henrik; Svendsen, P.; Oxlund, Hans; Gottrup, Finn; Hovendal, Claus

doi:10.1080/110241502320127784

Cited by 10 publications

(8 citation statements)

References 13 publications

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“…In experimental setting, a decreasing number of inflammation and fibroblast cells were identified in the suture line in the novel manual suture group compared with the conventional manual suture groups, which might cause disturbed anastomotic healing contributing to leakage and stricture formation, which may explain the gastrointestinal function recovery and rarity of anastomotic complication. [23–25]…”

Section: Discussionmentioning

confidence: 99%

Reduced rate of dehiscence after implementation of a novel technique for creating colonic anastomosis in pediatric patients undergoing intestinal anastomosis in a single institute

Yang¹,

Chen²,

et al. 2019

Medicine

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We aimed to investigate the new continuous horizontal mattress anastomosis for pediatric patients who underwent emergency or electively laparotomy. From June 2012 to June 2017, 858 patients undergoing intestinal anastomosis were reviewed retrospectively, including 369 patients with the new continuous horizontal mattress anastomosis and 489 patients with traditional 2 layer interrupted anastomosis, served as control. Propensity score matching was performed to adjust for selected baseline variables. The primary outcome, anastomosis complications and clinical outcomes, including postoperative gastrointestinal function recovery, overall expenditure, and postoperative hospital stay were compared between the 2 groups. Patients with the new manual anastomosis had advantageous postoperative outcomes than those with the traditional 2 layer interrupted anastomosis. A mean of 11.4 minutes was required to construct the new manual single-layer anastomosis versus 18.5 minutes for the traditional anastomosis ( P < .001). A reduction trend for postoperative anastomotic complications was indicated in patients receiving horizontal mattress anastomosis (odds ratio [OD] (95% confidence interval [CI]), 0.56 (0.37–0.84); P = .004), including peritonitis or abscess (OD [95% CI], 0.56 (0.32–0.98); P = .026), anastomotic leakage (OD [95% CI], 0.39 [0.12–1.27]; P = .088), and anastomotic strictures ( P = .26). Mean length of stay was 10.9 ± 2.9 days for the new manual anastomosis group and 11.3 ± 3.5 days for traditional 2-layer anastomosis patients ( P = .12). Beneficial effects of the new manual anastomosis were demonstrated in terms of anastomotic complications, and length of hospital stay in the pediatric patients. Furthermore, it is a novel, feasible and safe method that may simplify the surgical procedure in anastomoses.

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Section: Discussionmentioning

confidence: 99%

Reduced rate of dehiscence after implementation of a novel technique for creating colonic anastomosis in pediatric patients undergoing intestinal anastomosis in a single institute

Yang¹,

Chen²,

et al. 2019

Medicine

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“…In a study conducted on pigs, the SBS tube was able to reduce suture tension and helped in precision apposition of the cut ends, which are both critical in anastomotic healing. Once the ends were side-by-side, the sticky tube surface helped maintain the position and made the sewing easy and precise [50]. The reduced suture tension as a result of the SBS tension also reduced anastomotic ischemia, which further improved healing.…”

Section: Intraluminal Prosthesis (Sbs Tube)mentioning

confidence: 99%

Review of Colonic Anastomotic Leakage and Prevention Methods

Fang

Chao

Ecker

2020

JCM

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Although surgeries involving anastomosis are relatively common, anastomotic leakages are potentially deadly complications of colorectal surgeries due to increased risk of morbidity and mortality. As a result of the potentially fatal effects of anastomotic leakages, a myriad of techniques and treatments have been developed to treat these unfortunate cases. In order to better understand the steps taken to treat this complication, we have created a composite review involving some of the current and best treatments for colonic anastomotic leakage that are available. The aim of this article is to present a background review of colonic anastomotic leakage, as well as current strategies to prevent and treat this condition, for a broader audience, including scientist, engineers, and especially biomedical engineers.

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“…There was less tissue gap, less inflammation, and a higher breaking strength in the stented population, supporting the idea of internal stenting to prevent anastomotic leak. 48 A multicenter randomized control trial is ongoing to study the efficacy of the C-seal device (Polyganics BV, Groningen, the Netherlands) in preventing anastomotic leak. This device is an intraluminal soluble sheath that prevents content extravasation in the event of an anastomotic dehiscence.…”

Section: Other Adjunctive Measuresmentioning

confidence: 99%

Staple Line/Anastomotic Reinforcement and Other Adjuncts: Do They Make a Difference?

Betzold

Laryea

2014

Clinics in Colon and Rectal Surgery

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). CME Objectives: At the completion of this article the reader should be able to summarize the complications of stapled anastomoses and the various staple line reinforcement agents.The first gastrointestinal anastomosis was performed over 200 years ago.1 Since then, there has been a push to improve anastomotic techniques with the goals of reducing complications, standardizing methods, and reducing operative time. These goals led to the development of the surgical stapler and the subsequent technological improvements by Ravitch and Steichen.2 Before the use of circular staplers, many patients were treated with sphincter extirpation. Staple technology has allowed for these patients to be treated with low colorectal anastomoses. However, anastomotic complications, especially leaks, remain the Achilles heel of these procedures. These complications have the potential to be devastating, and the rate of anastomotic leak in colorectal surgery has remained significant, hence the pursuit of adjuncts and reinforcements for stapled anastomoses. Complications Associated with Stapled AnastomosesComplications related to stapled anastomoses include bleeding, device failure, and anastomotic failure, which include stricture or leak (►Table 1). Some of these complications can be directly related to the device itself, with at least 112 deaths resulting from 20,000 malfunctions in a recent review. AbstractSince the development of the stapled intestinal anastomosis, efforts have been aimed at reducing complications and standardizing methods. The main complications associated with stapled anastomoses include bleeding, device failure, and anastomotic failure (leaks and strictures). These complications are associated with increased cost of care, increase in cancer recurrence, decreased overall survival, poor quality of life, and in some cases the need for further procedures including a diverting ostomy. Reducing these complications therefore has important implications. To this end, techniques to reduce the incidence of anastomotic complications have been the focus of many investigators. In this review, we summarize the current staple line reinforcement technology as well as other adjunctive measures, and specifically discuss the role of biologic materials in this realm.

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An Intraluminal Prothesis may Improve Healing of a One-layer Colonic Anastomosis: An Experimental Study in Pigs

Abstract: We conclude that the SBS tube facilitates the sewing of the anastomosis and may improve healing, possibly because of better apposition of the cut ends and reduced tension in the sutures.

Cited by 10 publications

References 13 publications

Reduced rate of dehiscence after implementation of a novel technique for creating colonic anastomosis in pediatric patients undergoing intestinal anastomosis in a single institute

Reduced rate of dehiscence after implementation of a novel technique for creating colonic anastomosis in pediatric patients undergoing intestinal anastomosis in a single institute

Review of Colonic Anastomotic Leakage and Prevention Methods

Staple Line/Anastomotic Reinforcement and Other Adjuncts: Do They Make a Difference?

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