Document Detail

1.5:1 Meshed AlloDerm Bolsters for Stapled Rectal Anastomoses Does Not Provide Any Advantage in Anastomotic Strength in a Porcine Model.
MedLine Citation:
PMID:  20542954     Owner:  NLM     Status:  In-Data-Review    
METHODS: A total of 30 female 45-kg domestic pigs were studied, and each served as its own control by creating a bolstered and unbolstered anastomosis in each animal. All anastomoses were created with a 29-mm end-to-end stapling device. Bolstered anastomoses were randomized to proximal and distal positions along the rectum, and each rectorectal anastomosis was separated by an average of 10 cm. The animals were survived to 3, 5, and 30 days. Barium enemas were then performed and the 2 anastomotic sites harvested. Each anastomosis underwent burst testing. The internal diameter of each anastomosis was measured, and a biochemical analysis was performed for elastin and collagen content.
RESULTS: Bolstered anastomoses offered no strength advantage as burst pressures were no different when compared with unbolstered anastomoses. There was also no difference in anastomotic internal diameter, biochemical analysis of elastin or collagen, or presence of adhesions when comparing bolstered with unbolstered anastomoses. There were 4 subclinical leaks-1 in the unbolstered group and 3 in the bolstered group.
CONCLUSIONS: The routine use of 1.5:1 meshed AlloDerm sandwich bolsters in stapled rectal anastomosis does not confer any detectable advantage in anastomotic strength. Further studies are needed to determine equivalence to traditional stapled anastomoses.
Alyssa D Fajardo; Jonathan Chun; David Stewart; Bashar Safar; James W Fleshman
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Publication Detail:
Type:  Journal Article     Date:  2010-06-11
Journal Detail:
Title:  Surgical innovation     Volume:  18     ISSN:  1553-3514     ISO Abbreviation:  Surg Innov     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101233809     Medline TA:  Surg Innov     Country:  United States    
Other Details:
Languages:  eng     Pagination:  21-8     Citation Subset:  IM    
Washington University in St Louis, St Louis, MO, USA.
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