Anastomosenheilung bei verschiedenen Nahtverfahren im Gastrointestinaltrakt — Physiologie, experimentelle und klinische Ergebnisse

Lünstedt, B.; Debus, Sebastian; Thiede, A.

doi:10.1007/978-3-642-79044-7_1

Cited by 4 publications

(5 citation statements)

References 23 publications

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“…These high rates for open colorectal surgery are common knowledge. In his review of prospective studies, Lünstedt et al [25] found anastomotic leakage rates for stapled laparoscopic anastomoses ranging from 0% to 36%. Our own study of the literature revealed leakage rates of 0% to 11.8% for the upper rectum and 10.7% to 29% for the lower rectum [2,23].…”

Section: Discussionmentioning

confidence: 98%

Laparoscopic colorectal anastomosis: risk of postoperative leakage

et al. 1999

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Section: Discussionmentioning

confidence: 98%

Laparoscopic colorectal anastomosis: risk of postoperative leakage

et al. 1999

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“…It is known that primary wound healing is not possible in the gastrointestinal tract. Inflammation process is always identified in the line of the anastomosis especially in the submucosa 9–12 . One of the advantages of the single layer suture line is that the wound structure is simple and the exudate can freely leave through the sides of the wound 9,11–15 .…”

Section: Discussionmentioning

confidence: 99%

“…Inflammation process is always identified in the line of the anastomosis especially in the submucosa 9–12 . One of the advantages of the single layer suture line is that the wound structure is simple and the exudate can freely leave through the sides of the wound 9,11–15 . These conditions are given at telescopic anastomosis as well however, as a result of the sliding of submucosa and mucosa the suture line is isolated and the inflamed region slides farther from the stitches.…”

Section: Discussionmentioning

confidence: 99%

Experimental examination of the healing process of telescopic esophageal anastomosis

Szücs

Tóth

Barna

et al. 2003

Diseases of the Esophagus

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The basis of telescopic anastomosis is old, only the practical details of it have changed and improved. The telescopic anastomosis technique is successfully applied in our practice for reconstruction of gastrectomy and esophageal resection. The reason for this study was that data about the healing process of telescopic anastomosis had not been found in the literature. We used four groups of mongrel dogs for our experiments: Group A (n = 3) received 20 mm-long invaginations with a survival time of 7 days; Group B (n = 3) received 10 mm-long invaginations with a survival time of 21 days; Group C (n = 3) received 20 mm-long invaginations with a survival time of 21 days; Group D (n = 3) received 30 mm-long invaginations with a survival time of 21 days. At the end of the above survival times we removed the anastomosing area, measured the bursting pressures and performed morphological and histological examinations. In each case we also performed an anastomosis exactly the same as a completely healed anastomosis and its pressure tolerance was measured (0 day). The pressure tolerance within the anastomosis rises gradually and independently of the length of the invaginated esophageal part. Anastomosis leakage did not occur. The invaginated esophageal part did not suffer any damage. The muscular wall of the intragastric part of the esophagus became covered by the mucosa of the stomach during the healing process and it joined with the esophageal mucosa at the edge of the free end of the esophagus.

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“…After the healing process, the mucosal overlay gives protection for the invaginated section against the surrounding aggressive, foreign environment. According to our knowledge there is no primary wound healing in the gastrointestinal tract (Török and Karlinger, 1958;Langer et al, 1974;Langer and Kupczyk, 1982;Garth and Ballantyne, 1984;Lündstedt et al, 1993). Inflammation is always identified in the line of the anastomosis, especially in the submucosa.…”

Section: Discussionmentioning

confidence: 99%

“…Inflammation is always identified in the line of the anastomosis, especially in the submucosa. The advantage of the single-layer suture line is that the structure of the wound is simple, and the inflammatory exudates can pass out through the wound sides (Török and Karlinger, 1958;Langer et al, 1982;Harder and Kull, 1987;Lündstedt et al, 1993;Zoedler et al, 1995). These conditions are provided by telescopic anastomosis as well, but the sliding process of the mucosa-submucosa excludes the suture line from the inflammatory region.…”

Section: Discussionmentioning

confidence: 99%

Operation technique and healing process of telescopic ileocolostomy in dogs

Szücs¹,

Tóth

Barna

et al. 2003

Acta Veterinaria Hungarica

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The healing process of telescopic anastomoses was found in an animal experiment with 12 mongrel dogs. After the division of vessels an ileal segment of different length was invaginated into the lumen of the colon using single-layer interrupted sutures. The following four groups were used: Group A (n = 3): end-to-side ileocolostomy, single-layer interrupted suture (invagination length: 0 mm), survival time: 21 days. Group B (n = 3): invagination length: 20 mm, survival time: 7 days. Group C (n = 3): invagination length: 10 mm, survival time: 21 days. Group D (n = 3): invagination length: 20 mm, survival time: 21 days. At the end of the above survival times the anastomosis area was removed. The bursting pressure was measured and morphological as well as histological examinations were performed. In each case the 0-day look-alikes of anastomoses were performed using the remnant bowels, and bursting pressure measurements were done on these models as well. Anastomosis leakage did not occur. The serosal layer of the intracolonic part of the ileum disappeared during the healing process. The free surface of the intracolonic ileal segment became covered by the sliding mucosa of the colon and the prolapsing mucosa of the ileum. The following could be concluded after the experiments: The inner pressure tolerance of a telescopic ileocolostomy promptly after preparation is better than in case of another single-layer anastomosis. This fact results in increased safety against leakage on the first postoperative days. The inner pressure tolerance of the telescopic ileocolostomy increases during the healing process and it does not depend on the length of the invaginated part (0 day-20 mm: 56 mmHg ± 6, Group A: 252 ± 39, Group B: 154 ± 19, Group C: 249 ± 20, Group D: 298 ± 2). There is no difference in pressure tolerance between the telescopic and the end-to-side single-layer interrupted anastomoses after the healing process. The invaginated section within the lumen of the large intestine does not suffer ischaemic or any other kind of damage. This inexpensive and simple anastomosis technique could be useful in the veterinary surgical practice as well.

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Anastomosenheilung bei verschiedenen Nahtverfahren im Gastrointestinaltrakt — Physiologie, experimentelle und klinische Ergebnisse

Cited by 4 publications

References 23 publications

Laparoscopic colorectal anastomosis: risk of postoperative leakage

Laparoscopic colorectal anastomosis: risk of postoperative leakage

Experimental examination of the healing process of telescopic esophageal anastomosis

Operation technique and healing process of telescopic ileocolostomy in dogs

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