The use of a modified “end-to-side” small intestine anastomosis in patients with acute obstruction of the terminal section of the small and right colon

Abstract

Introduction. The prevalence of colorectal cancer in the world is increasing every year. In more than 40% of patients, the disease debuts with a clinical picture of acute intestinal obstruction, while in one third of cases the tumor is located in the right half of the colon. This leads to the necessity to perform colon resection or bypass surgery, the main stage of which is making entero- colic anastomosis. However, up to 15% of these anastomoses has a leakage. Development of methods of forming a reliable anastomosis is thus critical.Materials and methods. 37 patients with acute intestinal obstruction, divided into 2 groups (17 and 20 people), are included into the study. All of them, as a surgical stage of treatment, underwent a right hemicolectomy with the formation of an entero- colic anastomosis or a bypass surgery. A double-row side-to-side anastomosis was used in the comparison group, and a single-row “end-to-side” anastomosis in the main group (patent No. 2709253). The incidence of anastomotic leakage and mortality were assessed. Comparison was performed using Fisher’s exact test.Results. There were no cases of anastomotic leakage and mortality in the main group. In the comparison group, there were 5 leakages and 1 death.Discussion. When a modified entero-colic anastomosis is formed, adequate blood flow is maintained in the walls of the anastomosed intestinal loops, which contributes to adequate regeneration.Conclusion. The first clinical experience with the modified end-to-side entero- colic anastomosis is successful. It is planned to further recruit patients and study the features of the postoperative period.