Early detection of anastomotic leakage after hand-sewn colorectal anastomoses

Albatanony, Ayman A; Shahin, Marwa A.; Balpoush, Mohamed M.

doi:10.18203/2349-2902.isj20191051

Cited by 2 publications

(1 citation statement)

References 20 publications

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“…Провідну роль в порушенні загоєння кишкового шва належить внутрішньокишковій гіпертензії (ВКГ), яка виникає в результаті порушень моторно-евакуаторної функції шлунковокишкового тракту (ШКТ) у післяопераційному періоді [4,5,7]. При цьому зниження реальної механічної міцності і біологічної герметичності анастомозу відбувається з плином часу (t) від моменту операції -Р(t) [1,3].…”

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Formation of the Colon Anastomosis in Order to Provide High Level of Mechanical Strength and Hermeticity

Русин¹,

Chobey²,

Dutko³

2020

Khark. Surg. Sch.

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Summary. Aim of the study. Development and implementation of colon anastomoses formation method to improve their mechanical strength and biological hermeticity. Materials of the study. A comparative morphological study of the original and traditional two-row colonic anastomoses was performed in the experiment on 18 rabbits, and an assessment of their mechanical strength and biological hermeticity. The assessment of mechanical strength was defined by using a pneumopression technique. The assessment of biological hermeticity was defined by the method of culturing flushing water from the area of the anastomosis to the growth medium, species identification of isolated microorganisms using test systems and calculating the number of colony-forming units by quantitative method. Results of the research. The mechanical strength of one-row manual intra-nodular colonic anastomosis is higher by 66.3–85.4 %, respectively, of the first and seventh day of observations compared with the two-row manual anastomosis. During biological hermeticity assessment in the experimental group, in which colonic anastomosis was performed in the original method, the cultures were sterile at all stages of the sampling, whereas in the control group, where the traditional two-row manual anastomosis was formed, only from the seventh day all the cultures were sterile. Conslusions. The mechanical strength of one-row manual intra-nodular colonic anastomosis using atraumatic suture 4/0 without suturing the mucosa is higher by 66.3-85.4 %, respectively, of the first and seventh day of observations compared with the two-row manual anastomosis. Biological hermeticity of one-row manual intra-nodular colonic anastomosis is 100 % compared with the two-row manual anastomosis (28,5 %).

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Section: вступunclassified

Formation of the Colon Anastomosis in Order to Provide High Level of Mechanical Strength and Hermeticity

Русин¹,

Chobey²,

Dutko³

2020

Khark. Surg. Sch.

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Pathogenesis of failure in the anastomosis integrity and a prophylactic program in surgical treatment of the colon diseases.

Русин

Chobey

Dutko

2020

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Objective. To establish the impact of intraintestinal pressure on the intestinal anastomosis integrity and to propose a prophylactic measures of its insufficiency in surgical treatment of the colon diseases. Materials and methods. Intraintestinal pressure was measured in 30 patients, using Waldman method during 72 h postoperatively - before and after the transanal lavage (every 4 h). Primary operation - resection of sigmoid colon with formation of a one-barrel colostomy. The restoration intervention was performed in 3 mo with formation of a large-bowel anastomosis in accordance to the method elaborated (n=17), hand-made two-layered large-bowel anastomosis (n=3), and the apparatus large-bowel anastomosis (n=10). Results. There was noted the intraintestinal pressure raising during first 24 - 36 h up to (5.3 ± 0.1) mm Hg with its further lowering during 12 - 20 h down to (2.1 ± 0.3) mm Hg. In 20 min after the transanal drain lavage the intraintestinal pressure have lowered by (3.0 ± 1.3) mm Hg, and in 3 - 5 h - gradually raised. While application of a hand-made two-layered large-bowel anastomosis its insufficiency was observed (n=1) and anastomositis (n=1); and in the apparatus large-bowel anastomosis formation - anastomositis (n=1). While disorder of the intestinal suture healing the intraintestinal pressure have raised in 16 - 60 h up to (11.4 ± 0.2) mm Hg with peak at (16.3 - 17.1) mm Hg, which persisted 12 -18 h. Prophylactic measures were directed towards lowering of intraintestinal pressure and elimination of unfavorable local and general factors. Conclusion. While persisting noncorrected, the intraintestinal pressure in the 16.3 - 17.1 mm Hg borders during 12 - 18 h leads to complicated course of postoperative period. Direct and nondirect methods of decompression of the interintestinal anastomoses constitutes a basic prophylactic principle for it.

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Early detection of anastomotic leakage after hand-sewn colorectal anastomoses

Cited by 2 publications

References 20 publications

Formation of the Colon Anastomosis in Order to Provide High Level of Mechanical Strength and Hermeticity

Formation of the Colon Anastomosis in Order to Provide High Level of Mechanical Strength and Hermeticity

Pathogenesis of failure in the anastomosis integrity and a prophylactic program in surgical treatment of the colon diseases.

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