Document Detail


Direct comparison between Czerny-Lembert and circular-stapled anastomotic techniques in colorectal anastomosis: a similar pattern of healing for both.
MedLine Citation:
PMID:  1511647     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
There are scant experimental data directly comparing the healing of the circular-stapled (CS) anastomotic technique with the standard Czerny-Lembert two-layer hand-sewn (HS) anastomotic technique during the acute and chronic phases of healing. The purpose of this study, therefore, was to serially evaluate wound healing in CS and HS anastomoses in the normal porcine colorectum. Forty-two adult female mixed-breed pigs randomly underwent either HS or CS anastomosis at the sacral promontory. Laser Doppler velocimetry (LDV), was used to measure perianastomotic blood flow. Groups of animals underwent a second surgery at 3, 5, 11, 60, or 120 days postoperatively, and anastomoses were restudied using LDV, gross and microscopic grading of inflammation, bursting pressures, and hydroxyproline content. Additionally, the 60-day and 120-day groups of animals underwent preoperative biplanar barium enemas to identify leaks or stenoses. No significant differences in perianastomotic blood flow between the HS and CS techniques were obtained over the entire 120-day study period. Serial evaluation of wound healing revealed no significant differences between the two anastomotic techniques with respect to bursting pressures, gross or microscopic inflammatory scores, or hydroxyproline content. There were no leaks or stenoses with either technique. Despite earlier reports to the contrary, there appears to be no fundamental difference in the mode of healing in the porcine colorectum comparing the HS technique with the CS technique.
Authors:
A Senagore; J W Milsom; R K Walshaw; R Dunston; I H Chaudry
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  35     ISSN:  0012-3706     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  1992 Sep 
Date Detail:
Created Date:  1992-09-29     Completed Date:  1992-09-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  862-9     Citation Subset:  IM    
Affiliation:
Department of Surgical Research, Ferguson Clinic, Grand Rapids, Michigan.
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MeSH Terms
Descriptor/Qualifier:
Anastomosis, Surgical / methods
Animals
Collagen / biosynthesis
Colon / blood supply,  pathology,  physiology,  surgery*
Female
Inflammation / pathology
Random Allocation
Rectum / blood supply,  pathology,  physiology,  surgery*
Surgical Staplers*
Suture Techniques*
Swine
Tensile Strength
Wound Healing*
Chemical
Reg. No./Substance:
9007-34-5/Collagen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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