Stapled Side-to-Side Anastomosis Might Be Better Than Handsewn End-to-End Anastomosis in Ileocolic Resection for Crohn’s Disease: A Meta-Analysis

He, Xiaosheng; Chen, Zexian; Jing, Huang; Lian, Lei; Rouniyar, Santosh; Wu, Xiaojian; Lan, Ping

doi:10.1007/s10620-014-3039-0

Cited by 103 publications

(49 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Specifically for ileocolic anastomosis, however, a recent meta-analysis showed that a side-to-side stapled anastomosis is associated with decreased rates of anastomotic leak and decreased surgical recurrence[109]. …”

Section: Technical Considerations In Surgery For CDmentioning

confidence: 99%

Indications and surgical options for small bowel, large bowel and perianal Crohn's disease

Toh¹,

Stewart²,

Rickard³

et al. 2016

WJG

View full text Add to dashboard Cite

Despite advancements in medical therapy of Crohn’s disease (CD), majority of patients with CD will eventually require surgical intervention, with at least a third of patients requiring multiple surgeries. It is important to understand the role and timing of surgery, with the goals of therapy to reduce the need for surgery without increasing the odds of emergency surgery and its associated morbidity, as well as to limit surgical recurrence and avoid intestinal failure. The profile of CD patients requiring surgical intervention has changed over the decades with improvements in medical therapy with immunomodulators and biological agents. The most common indication for surgery is obstruction from stricturing disease, followed by abscesses and fistulae. The risk of gastrointestinal bleeding in CD is high but the likelihood of needing surgery for bleeding is low. Most major gastrointestinal bleeding episodes resolve spontaneously, albeit the risk of re-bleeding is high. The risk of colorectal cancer associated with CD is low. While current surgical guidelines recommend a total proctocolectomy for colorectal cancer associated with CD, subtotal colectomy or segmental colectomy with endoscopic surveillance may be a reasonable option. Approximately 20%-40% of CD patients will need perianal surgery during their lifetime. This review assesses the practice parameters and guidelines in the surgical management of CD, with a focus on the indications for surgery in CD (and when not to operate), and a critical evaluation of the timing and surgical options available to improve outcomes and reduce recurrence rates.

show abstract

Section: Technical Considerations In Surgery For CDmentioning

confidence: 99%

Indications and surgical options for small bowel, large bowel and perianal Crohn's disease

Toh¹,

Stewart²,

Rickard³

et al. 2016

WJG

View full text Add to dashboard Cite

show abstract

“…In gastrointestinal anastomoses, anastomotic leakage and bleeding from the anastomotic site are life-threatening critical complications, with a reported incidence of approximately 10% [1], [2], [3], [4], [5], [6], [7], [8], [9]. Since the use of an automatic suture device was reported in 1968, various automatic suture devices have been developed and evaluated to reduce the incidence of complications [10], [11], [12], [13], [14], [15].…”

Section: Discussionmentioning

confidence: 99%

“…After gastrointestinal anastomosis, postoperative complications, such as anastomotic leakage, bleeding, and stricture, may occur [1], [2], [3], [4], [5], [6], [7], [8], [9]. Functional end-to-end anastomosis (FEEA) is a type of gastrointestinal anastomosis using an automatic suture device that was first reported in 1968 [10].…”

Section: Introductionmentioning

confidence: 99%

Sutureless functional end-to-end anastomosis using a linear stapler with polyglycolic acid felt for intestinal anastomoses

Naito

Miura

Nakamura

et al. 2017

Annals of Medicine &Amp; Surgery

View full text Add to dashboard Cite

BackgroundGastrointestinal anastomosis remains associated with a considerable burden of morbidity and, in some cases, mortality. Functional end-to-end anastomosis, whilst extremely efficient, is vulnerable to increased intestinal pressure in the immediate postoperative period, which may predispose to development of anastomotic leakage or bleeding. Therefore, there is a requirement for new techniques that facilitate safe and efficacious anastomotic procedures.Materials and methodsThis study examined the clinical application of functional end-to-end anastomosis with a stapler that automatically applies a bioabsorbable polyglycolic acid sheet (Endo GIA™ Reinforced Reload with Tri-Staple™ Technology). A porcine model was used to examine functional end-to-end anastomosis with and without application of a bioabsorbable polyglycolic acid sheet. As the crotch of the anastomosis is considered the weakest point, a probe was used to test the integrity of these anastomoses. Furthermore, we performed functional end-to-end anastomosis using the Endo GIA™ Reinforced stapler in a clinical series of 20 patients undergoing gastrointestinal tract resection. In all cases, functional end-to-end anastomosis was performed without suture reinforcement.ResultsSmall intestine anastomoses in the animal study exhibited no weakness at the crotch of the anastomosis, as tested with a probe, suggesting an increased resiliency to conventional complications of functional end-to-end anastomosis. In the clinical population, no postoperative complications were noted. No adhesive intestinal obstruction was noted.ConclusionSutureless functional end-to-end anastomosis using the Endo GIA™ Reinforced appears to be safe, efficacious, and straightforward. Reinforcement of the crotch site with a bioabsorbable polyglycolic acid sheet appears to mitigate conventional problems with crotch-site vulnerability.

show abstract

“…This may in turn inhibit gastrointestinal transit. Enteric anastomosis is essential for restoring the integrity of the gastrointestinal tract following resection of the diseased bowel segment [24], but possible associations between anastomotic type and surgical outcome are controversial [25]. A side-to-side (also called functional end-to-end) anastomosis is constructed by passing a linear cutter stapler through the target enterotomies to create an anastomosis [26,27].…”

Section: Discussionmentioning

confidence: 99%

Factors associated with failure of enhanced recovery programs after laparoscopic colon cancer surgery: a single-center retrospective study

Ihn

Son

et al. 2015

Surg Endosc

View full text Add to dashboard Cite

show abstract

Stapled Side-to-Side Anastomosis Might Be Better Than Handsewn End-to-End Anastomosis in Ileocolic Resection for Crohn’s Disease: A Meta-Analysis

Abstract: Based on the results of our meta-analysis, SSSA would appear to be the preferred procedure after ileocolic resection for CD, with reduced overall postoperative complications, especially anastomotic leak, and a decreased recurrence and re-operation rate.

Cited by 103 publications

References 33 publications

Indications and surgical options for small bowel, large bowel and perianal Crohn's disease

Indications and surgical options for small bowel, large bowel and perianal Crohn's disease

Sutureless functional end-to-end anastomosis using a linear stapler with polyglycolic acid felt for intestinal anastomoses

Factors associated with failure of enhanced recovery programs after laparoscopic colon cancer surgery: a single-center retrospective study

Contact Info

Product

Resources

About