Document Detail


Does a proximal colostomy affect colorectal anastomotic healing?
MedLine Citation:
PMID:  1735322     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Fecal diversion has been implicated as an etiologic factor in anastomotic stenosis following colorectal surgery, particularly following the use of circular anastomotic stapling devices. However, experimental confirmation of the effects of fecal diversion on anastomotic healing is virtually nonexistent. The purpose of this study was to serially evaluate colorectal anastomotic healing with proximal colostomy (COL) and without it (CON; control) using two anastomotic techniques in a porcine model. Fifty-two (28 CON; 24 COL) mixed-breed female pigs had colorectal anastomoses using either a two-layer hand-sewn (HS) or an EEA (U.S. Surgical Corporation, Norwalk, CT) circular stapled (CS) technique. Anastomotic blood flow was measured using laser Doppler velocimetry (LDV). At second surgery (5, 11, 60, or 120 days postoperatively), the following data were collected: repeat LDV, gross and microscopic anastomotic inflammatory scores, anastomotic diameter, and bursting pressure. There were no significant differences in anastomotic blood flow (LDV), inflammatory scores, or incidence of leak or stenosis between the CON and COL groups or between anastomotic techniques. Bursting pressure was significantly lower for the COL group at day 11 but not any other postoperative day (POD). Proximal colostomy does not appear to exert adverse effects on colorectal anastomotic healing. The choice of colorectal anastomotic technique should not be influenced by the need for proximal colostomy.
Authors:
A Senagore; J W Milsom; R K Walshaw; R Dunstan; I H Chaudry
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  35     ISSN:  0012-3706     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  1992 Feb 
Date Detail:
Created Date:  1992-03-12     Completed Date:  1992-03-12     Revised Date:  2003-11-14    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  182-8     Citation Subset:  IM    
Affiliation:
Department of Surgical Research, Ferguson Clinic, Grand Rapids, Michigan 49503.
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MeSH Terms
Descriptor/Qualifier:
Anastomosis, Surgical
Animals
Colon / blood supply,  pathology,  surgery*
Colostomy*
Female
Rectum / blood supply,  pathology,  surgery*
Regional Blood Flow
Surgical Staplers
Sutures
Swine
Wound Healing*

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


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