The effect of three different surgical techniques for colon anastomosis on regional postoperative microperfusion: Laser Doppler Flowmetry study in pigs.

BACKGROUND: The optimal surgical approach to reconnecting bowel ends safely after resection is of great importance. OBJECTIVES: This project is focused on assessment of the perianastomotic microcirculation quality in the short postoperative period when using three different anastomosis techniques in experimental animal. METHODS: The experimental study involved 27 young female domestic pigs divided into three subgroups of 9 animals according to each surgical method of anastomosis construction in the sigmoid colon region: by manual suture, by stapler, or by gluing. Blood microcirculation in the anastomosis region was monitored using Laser Doppler Flowmetry (LDF). Anastomosis healing was evaluated by macroscopic and histological examination. RESULTS: Evaluation of the microcirculation in the anastomosis region showed the smallest decrease in perfusion values in animals reconstructed by suturing (Δ= -38.01%). A significantly more profound drop was observed postoperatively after stapling or gluing (Δ= -52.42% and Δ= -59.53%, respectively). All performed anastomoses healed without any signs of tissue and function pathology. CONCLUSIONS: Sewing, stapling, and gluing techniques for bowel anastomosis each have a different effect on regional microcirculation during 120 min. postoperatively. Nevertheless, the final results of anastomosis healing were found without of any pathology in all experimental animals managed by above mentioned anastomotic techniques.

Glued versus stapled anastomosis of the colon: an experimental study to determine comparative resistance to intraluminal pressure.

BACKGROUND: This study compared the resistance of glued versus stapled anastomosis of the colon to intraluminal pressures at different times during healing. METHODS: Forty seven female domestic pigs, mean weight of 30.7 kg, were used. Maximum physiological luminal pressures, i.e. the pressure resisted by a catheter inserted into the intestinal lumen via a puncture without it being released and without injury to the surrounding intestinal wall, was performed in 5 control animals. The remaining 42 animals were divided into 3 groups of 14 animals each based on time from anastomosis construction. Each group was divided into 2 subgroups with stapled or glued anastomoses. Intraluminal pressure was measured on the first, third, and fifth day post-surgery. RESULTS: The maximum pressures resisted by anastomoses were significantly higher than the physiological pressures in all groups. At all time points, stapled anastomoses resisted higher intraluminal pressures than glued ones. However, glued anastomoses resisted pressures significantly higher than physiological pressure. As healing advanced, glued anastomoses neared the resistance to intraluminal pressures of stapled anastomoses. CONCLUSION: Healing with absorbable synthetic glue was as good as with staples. Glued anastomoses resisted pressures that were statistically significantly higher than physiological intraluminal colon pressures but lower than stapled ones.