Document Detail

Hand-sewn versus stapled intestinal anastomoses in a chronically steroid-treated porcine model.
MedLine Citation:
PMID:  15011919     Owner:  NLM     Status:  MEDLINE    
Chronic steroid treatment is known to delay wound healing; however, there are no trials examining stapled intestinal anastomoses in subjects chronically treated with steroids. The current study compares mechanically stapled to manually sutured intestinal anastomoses in a steroid-treated porcine model. Twenty adult male pigs were treated with daily prednisolone (0.5 mg/kg IM) for 14 days. The pigs were divided between hand-sewn and stapled groups. All pigs underwent a laparotomy with construction of a jejunojejunostomy, an ileocecostomy, and a colocolostomy. Pigs were sacrificed on postoperative day 4. Bursting pressure, collagen content, and inflammatory scores were used to evaluate each anastomosis. Bursting pressure was greater for the hand-sewn group at the jejunojejunostomies only (1.52 vs 0.79 psi; P < 0.001). The collagen content and microscopic inflammatory scores were not significantly different at any location. The mean gross inflammatory score was greater for the hand-sewn colocolostomies only (5.20 vs 4.00; P < 0.01). Stapled ileocecostomies and colocolostomies appear to heal as well as hand-sewn anastomoses. This may not be true of the jejunojejunostomies as evidenced by the decreased bursting pressures. These data may provide evidence in support of the use of stapled anastomoses in steroid-treated patients.
Marc A Singer; José R Cintron; Enrico Benedetti; Amit Lamba; Herand Abcarian
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American surgeon     Volume:  70     ISSN:  0003-1348     ISO Abbreviation:  Am Surg     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-03-11     Completed Date:  2004-03-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  151-6; discussion 156     Citation Subset:  IM    
Department of Surgery , University of Illinois, Chicago, Illinois 60612, USA.
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MeSH Terms
Enterostomy / methods*
Glucocorticoids / adverse effects,  therapeutic use*
Prednisolone / adverse effects,  therapeutic use*
Surgical Wound Dehiscence / prevention & control*
Reg. No./Substance:
0/Glucocorticoids; 50-24-8/Prednisolone

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

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