The Stapled Gastrointestinal Tract Anastomosis

Chassin, Jameson L.; Rifkind, Kenneth; Sussman, Barry; Kassel, Barry; Fingaret, Arnold; Drager, Sharon; Chassin, Pamela S.

doi:10.1097/00000658-197811000-00019

Cited by 120 publications

(14 citation statements)

References 9 publications

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“…In experiment 3, the wide technique of FETEA with EndoGIA 60 blue had a broad circumference and good patency, whereas buttressing did not influence the circumference. These results suggest that the modification proposed by Chassin et al [3] produces a larger anastomosis at the initial phase. We examined acute phase data in this study.…”

Section: Discussionsupporting

confidence: 56%

Evaluation of the mechanical strength and patency of functional end-to-end anastomoses

et al. 2007

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Section: Discussionsupporting

confidence: 56%

Evaluation of the mechanical strength and patency of functional end-to-end anastomoses

et al. 2007

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“…However, some articles have pointed out that stapling anastomoses are unfavorable under certain circumstances [4]. Inflammatory bowel disease is thought to be one of the risky conditions for anastomotic complications [4, 5]. …”

Section: Introductionmentioning

confidence: 99%

A Comparison of Stapled and Hand-Sewn Anastomoses in Crohn’s Disease

et al. 1998

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Sixty-eight patients with Crohn’s disease who underwent intestinal resection were randomly divided into 2 groups: the stapled group (32 patients, 40 anastomoses) with functional end-to-end anastomoses made with linear staplers and with circular stapling anastomoses, and the hand-sewn group (36 patients, 48 anastomoses), with anastomoses achieved by layer-to-layer suturing. There were no significant differences in operative indications, age, sex, blood loss, or length of hospital stay between the groups. The operation times for right hemicolectomy and total colectomy in the stapled group were significantly shorter than those in the hand-sewn group. There were no significant differences in anastomotic dehiscence or recurrence between the stapling and hand-sewn procedures. These results indicate that these stapling techniques, even though producing an everted anastomosis, are not an adverse procedure for Crohn’s disease.

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“…The other 24 found that patients with stapled anastomoses were less likely to experience dehiscence than those with sutured anastomoses, particularly in the presence of preoperative septic peritonitis. Reports 25–29 on this topic in the human medical literature have conflicting results. In light of the high mortality rates associated with intra-abdominal complications in veterinary patients, and considering the financial burden to owners when a second surgery is required, it is desirable to identify the anastomotic technique with the lowest rate of intra-abdominal complications regardless of differences in preoperative variables, pathogenesis of the condition that necessitates surgery, or anatomic site of the anastomosis.…”

mentioning

confidence: 99%

Intra-abdominal complications following intestinal anastomoses by suture and staple techniques in dogs

DePompeo¹,

Bond²,

George³

et al. 2018

javma

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OBJECTIVE To compare the incidence of intra-abdominal complications in dogs following resection and functional end-to-end stapled anastomosis (FEESA) versus anastomosis with an end-to-end sutured technique for treatment of enteric lesions. DESIGN Multicenter, retrospective descriptive cohort study. ANIMALS 180 dogs. PROCEDURES Medical records of dogs undergoing intestinal resection and anastomosis at 3 nonaffiliated private practice specialty centers were retrospectively reviewed. Preoperative clinical variables, indication for surgery, surgical technique (sutured end-to-end anastomosis vs FEESA), and evidence of postoperative anastomosis site leakage (dehiscence) were recorded. Variables of interest were analyzed for associations with dehiscence. RESULTS Dehiscence rates of sutured and stapled anastomoses were 12 of 93 (13%) and 4 of 87 (5%), respectively; odds of postoperative dehiscence were significantly lower for dogs with FEESAs than for dogs with sutured anastomoses (OR, 0.28; 95% confidence interval, 0.09 to 0.94). Among dogs that underwent surgery for treatment of intestinal dehiscence after surgery at another facility, subsequent dehiscence developed in 3 of 5 with sutured anastomoses and 0 of 11 with stapled anastomoses. Dehiscence rates varied significantly among clinics. No other variable was associated with risk of dehiscence. Eleven of 16 dogs with dehiscence were euthanized without additional surgery. Impaction at the anastomosis site was identified months or years after surgery in 3 dogs (4 anastomosis sites) that had FEESAs. CONCLUSIONS AND CLINICAL RELEVANCE Odds for dehiscence were significantly greater for sutured end-to-end anastomoses than FEESAs, and dogs undergoing surgery for previous dehiscence were significantly more likely to experience a subsequent dehiscence with a sutured anastomosis. However, variability of procedure types and dehiscence rates among clinics suggested further research is needed to confirm these findings. Obstruction at the anastomosis site was identified as a potential long-term complication of FEESA.

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The Stapled Gastrointestinal Tract Anastomosis

Cited by 120 publications

References 9 publications

Evaluation of the mechanical strength and patency of functional end-to-end anastomoses

Evaluation of the mechanical strength and patency of functional end-to-end anastomoses

A Comparison of Stapled and Hand-Sewn Anastomoses in Crohn’s Disease

Intra-abdominal complications following intestinal anastomoses by suture and staple techniques in dogs

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