Colonic anastomosis: A clinical and experimental study

Comparison of single-layer inverting, two-layer inverting, and everting anastomoses in the rabbit colon

“…7 shows the typical appearance of an everting anastomosis at 7 days and there is no definite evidence of connectivetissue or mucosal union. strength and healing of everting anastomoses in the rabbit colon were distinctly inferior to those found in inverting anastomoses and similar observations have been reported in previous experimental studies (Loeb, 1967;Hargreaves and Keddie, 1968;Mellish, Ty, and Keller, 1968;Gill, Fraser, Carter, and Hill, 1969;Trueblood, Nelson, Kohatsu, and Oberhelman, 1969; Abramowitz and Butcher, 1971). It is surprising, perhaps, that the collagen content of everting anastomoses, many of which were leaking or in close proximity to peritoneal sepsis, was no different from that found in inverting anastomoses, but Hawley (1972) found that the total collagen or hydroxyproline content of an anastomosis was not significantly altered in the presence of anastomotic dehiscence since increased lysis of mature collagen was matched by an increased rate of collagen synthesis in such cases.…”

A controlled trial of inverting versus everting intestinal suture in clinical large-bowel surgery

“…Our decision to set up this clinical trial was instigated by the mainly favourable results of the animal experimental work on everting intestinal suture up to early 1968. It is interesting to note that since then much additional animal research along the same lines has been performed (Canalis and Ravitch, 1968;Mellish, Ty, and Keller, 1968;Singleton, White, and Montalbo, 1968;Hargreaves and Keddie, 1968;Gill, Fraser, Carter, and Hill, 1969;McAdams, Meikle, and Medina, 1969;Orr, 1969;Rusca, Bornside, and Cohn, 1969;Trueblood, Nelson, Kohatsu, and Oberhelman, 1969), with all but Orr (1969) coming out strongly in support of the conventional inverting technique and against the everting method. Possibly, indeed, if these more recent experimental data had been available at an earlier stage we might never have embarked on our clinical study.…”

Editorial: Anastomotic leakage.

“…These findings are supported by numerous recent clinical and experimental studies. [5][6][7][8][9][10] Other determining factors, both local and general, have recently come under scrutiny. Irvin and Goligher", in a study of 204 patients undergoing resections of the colon, found that 28 (14%) had clinical evidence of anastomotic dehiscence and 10 of these died.…”