Comparison of Postoperative Motility in Hand-Sewn End-to-End Anastomosis and Functional End-to-End Anastomosis: An Experimental Study in Conscious Dogs

Toyomasu, Yoshitaka; Mochiki, Erito; Ando, Hiroyuki; Yanai, Mitsuhiro; Ogata, Kenichi; Tabe, Yuichi; Ohno, Tetsuro; Aihara, Ryuusuke; Kuwano, Hiroyuki

doi:10.1007/s10620-009-1040-9

Cited by 8 publications

(4 citation statements)

References 14 publications

(17 reference statements)

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“…Although delayed aboral transit of ingesta across side-to-side anastomoses (compared with that through end-to-end anastomoses) has been reported, it has been shown that intestinal motility in either conformation is not significantly different from that of healthy dogs that have not undergone intestinal surgery. 34,35 Trichobezoar obstruction at a circular end-to-end stapled anastomosis site has been reported and was presumed to result from entanglement with the exposed regions of staples in the intestinal lumen. 36 These reports, along with the occurrence of impactions at some of the previously stapled anastomosis sites for dogs in our study that required additional surgery, may indicate the need for development of absorbable staple materials to decrease the risk of this complication.…”

Section: Discussionmentioning

confidence: 99%

Intra-abdominal complications following intestinal anastomoses by suture and staple techniques in dogs

DePompeo¹,

Bond²,

George³

et al. 2018

javma

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OBJECTIVE To compare the incidence of intra-abdominal complications in dogs following resection and functional end-to-end stapled anastomosis (FEESA) versus anastomosis with an end-to-end sutured technique for treatment of enteric lesions. DESIGN Multicenter, retrospective descriptive cohort study. ANIMALS 180 dogs. PROCEDURES Medical records of dogs undergoing intestinal resection and anastomosis at 3 nonaffiliated private practice specialty centers were retrospectively reviewed. Preoperative clinical variables, indication for surgery, surgical technique (sutured end-to-end anastomosis vs FEESA), and evidence of postoperative anastomosis site leakage (dehiscence) were recorded. Variables of interest were analyzed for associations with dehiscence. RESULTS Dehiscence rates of sutured and stapled anastomoses were 12 of 93 (13%) and 4 of 87 (5%), respectively; odds of postoperative dehiscence were significantly lower for dogs with FEESAs than for dogs with sutured anastomoses (OR, 0.28; 95% confidence interval, 0.09 to 0.94). Among dogs that underwent surgery for treatment of intestinal dehiscence after surgery at another facility, subsequent dehiscence developed in 3 of 5 with sutured anastomoses and 0 of 11 with stapled anastomoses. Dehiscence rates varied significantly among clinics. No other variable was associated with risk of dehiscence. Eleven of 16 dogs with dehiscence were euthanized without additional surgery. Impaction at the anastomosis site was identified months or years after surgery in 3 dogs (4 anastomosis sites) that had FEESAs. CONCLUSIONS AND CLINICAL RELEVANCE Odds for dehiscence were significantly greater for sutured end-to-end anastomoses than FEESAs, and dogs undergoing surgery for previous dehiscence were significantly more likely to experience a subsequent dehiscence with a sutured anastomosis. However, variability of procedure types and dehiscence rates among clinics suggested further research is needed to confirm these findings. Obstruction at the anastomosis site was identified as a potential long-term complication of FEESA.

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Section: Discussionmentioning

confidence: 99%

Intra-abdominal complications following intestinal anastomoses by suture and staple techniques in dogs

DePompeo¹,

Bond²,

George³

et al. 2018

javma

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“…[2][3][4]6,9,11,12 Only two cases reported that the dogs were hospitalised for 2 days postoperatively, 3,9 while the rest lacked related information. 2,4,6,11,12 In our case, 4 days of hospitalization were initially suggested to minimize the risk of small intestine dehiscence which is higher on the third day 25 and to monitor the dog until completion of the lag phase of intestinal healing, 25 but the owner decided to take his dog home one day earlier, due to financial restraints.…”

Section: Discussionmentioning

confidence: 96%

Acute intestinal obstruction after methylene‐diphenyl‐diisocyanate‐based glue ingestion in a dog

Markou¹,

Anatolitou²

2021

Vet Record Case Reports

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A 2-year-old, male German Shepherd dog with a history of chronic diarrhea was presented for restlessness and vomiting 4 hours after chewing a plastic container with methylene-diphenyl-diisocyanate (MDI)-based glue. Clinical examination revealed dehydration, fever and a large painful rigid mass in the cranial abdomen. Abdominal radiography showed a radiopaque, round, cranial abdominal mass, along with air-filled loops proximally and distally. Except for leukocytosis, high blood haematocrit and increased total proteins, blood and serum analysis tests were normal. After initial stabilization, the foreign body was removed, along with part of the jejunum, through enterectomy and enteroanastomosis. On macroscopic evaluation, the foreign body was embedded in the intestinal mucosa. The dog recovered uneventfully. To the authors' knowledge, this is the first reported case of intestinal obstruction after MDI-based glue ingestion in a dog.

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“…Interestingly, the term “functional end-to-end anastomosis” [ 5 ] was used both in ASSA and Kono-S anastomosis [ 21 ]. As a matter of fact, ASSA is not “end-to-end” but “side-to-side” in configuration, and experimental studies [ 22 23 24 ] have also proved ASSA was less functional than end-to-end anastomosis regarding intestinal motility and bacterial growth. From this viewpoint, Kono-S anastomosis might better deserve the naming of “functional end-to-end anastomosis.” Secondly, intervening mesentery in both ISSA and Kono-S can be divided close to the bowel, resulting in better preservation of vascularization and innervation [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Isoperistaltic side-to-side anastomosis for the surgical treatment of Crohn disease

et al. 2022

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Purpose Increasing evidence has shown an association of surgical technique, particularly anastomotic configuration, with postoperative recurrence of CD. This pilot study aimed to evaluate short-term outcomes of isoperistaltic side-to-side anastomosis (ISSA) employed on Crohn disease (CD) patients. Methods Data were retrieved from a prospectively maintained database. Postoperatively, all patients were followed up with close endoscopic (ileocolonoscopy) surveillance. Results From January 2017 to May 2021, 30 patients diagnosed with CD who underwent ISSA were compared with 45 CD patients who underwent antiperistaltic side-to-side anastomosis (ASSA). The 2 groups were comparable in baseline demographics and clinical characteristics. No significant differences were observed between groups regarding postoperative safety issues, including anastomotic leak, abdominal/pelvic abscess, length of hospital stay, readmission rate within 30 days, etc. At postoperative 24th month, reduced endoscopic recurrence was observed in the ISSA group compared with that in the ASSA group (18 of 24, 75.0%, vs. 36 of 38, 94.7%; P = 0.024). Regarding surgical recurrence, there was 0% in the ISSA group vs. 4.4% (2 of 45) in the ASSA group (P = 0.510). Conclusion In this study, we aimed to explore the influence of ISSA on postoperative recurrence in CD patients, and the preliminary results show that ISSA was technically safe and feasible, and appears to be effective in reducing postoperative recurrence in CD patients. However, our conclusion was underpowered due to small sample size and inadequate follow-up. We proposed ISSA be considered as another alternative option in the toolbox of inflammatory bowel disease surgeons when performing anastomosis on CD patients.

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Comparison of Postoperative Motility in Hand-Sewn End-to-End Anastomosis and Functional End-to-End Anastomosis: An Experimental Study in Conscious Dogs

Cited by 8 publications

References 14 publications

Intra-abdominal complications following intestinal anastomoses by suture and staple techniques in dogs

Intra-abdominal complications following intestinal anastomoses by suture and staple techniques in dogs

Acute intestinal obstruction after methylene‐diphenyl‐diisocyanate‐based glue ingestion in a dog

Isoperistaltic side-to-side anastomosis for the surgical treatment of Crohn disease

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