Biomaterial Database

Early colonic anastomotic edema. Evaluation of stapled vs. hand-sewn anastomoses. 1988

R A Kozol, and M Mulligan, and R J Downes, and F A Forouhar, and D L Kreutzer

Department of Surgery, University of Connecticut School of Medicine, Farmington 06032.

Early dysfunction of intestinal anastomoses is sometimes blamed on anastomotic edema. This study compares stapled and hand-sewn anastomoses for the development of early anastomotic edema. After segmental colon resections, one group of dogs was reconstructed with two-layered handsewn anastomoses, and the other group had stapled anastomoses. Controls were untouched small bowel in each operated animal and untouched colon in a separate group of dogs. At 24 hours postoperatively, all animals were given 125I albumin and at 28 hours the animals were killed, venous blood was obtained, and the anastomoses were harvested. Tissue levels of 125I albumin were measured at 1-mm and 1-cm distances from each anastomosis and compared with controls. This quantitative measure of edema was compared with the histologic appearance of the tissue specimens. The results show significant edema formation in both stapled and handsewn anastomoses compared with control tissues (P less than .05 for each animal). Although quantitative and histologic results demonstrate less edema in the stapled group, the difference is not significant by the Wilcoxin rank test. These and similar studies may allow improvement in surgical technique.

UI	MeSH Term	Description	Entries
D007413	Intestinal Mucosa	Lining of the INTESTINES, consisting of an inner EPITHELIUM, a middle LAMINA PROPRIA, and an outer MUSCULARIS MUCOSAE. In the SMALL INTESTINE, the mucosa is characterized by a series of folds and abundance of absorptive cells (ENTEROCYTES) with MICROVILLI.	Intestinal Epithelium,Intestinal Glands,Epithelium, Intestinal,Gland, Intestinal,Glands, Intestinal,Intestinal Gland,Mucosa, Intestinal
D008297	Male		Males
D011183	Postoperative Complications	Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.	Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D003106	Colon	The segment of LARGE INTESTINE between the CECUM and the RECTUM. It includes the ASCENDING COLON; the TRANSVERSE COLON; the DESCENDING COLON; and the SIGMOID COLON.	Appendix Epiploica,Taenia Coli,Omental Appendices,Omental Appendix,Appendices, Omental,Appendix, Omental
D004285	Dogs	The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065)	Canis familiaris,Dog
D004487	Edema	Abnormal fluid accumulation in TISSUES or body cavities. Most cases of edema are present under the SKIN in SUBCUTANEOUS TISSUE.	Dropsy,Hydrops,Anasarca
D000714	Anastomosis, Surgical	Surgical union or shunt between ducts, tubes or vessels. It may be end-to-end, end-to-side, side-to-end, or side-to-side.	Surgical Anastomosis,Anastomoses, Surgical,Surgical Anastomoses
D000818	Animals	Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA.	Animal,Metazoa,Animalia
D013528	Surgical Staplers	Fastening devices composed of steel-tantalum alloys used to close operative wounds, especially of the skin, which minimizes infection by not introducing a foreign body that would connect external and internal regions of the body. (From Segen, Current Med Talk, 1995)	Stapler, Surgical,Staplers, Surgical,Surgical Stapler
D013537	Sutures	Materials used in closing a surgical or traumatic wound. (From Dorland, 28th ed)	Staples, Surgical,Surgical Staples,Staple, Surgical,Surgical Staple,Suture