Abstract
By performing a colorectal anastomosis, the risk of a serious clinical leakage is about 10 percent. On the basis of this, the current study describes a combined fibrin adhesive-sutured anastomosis in the rectum performed with interrupted seromuscular sutures externally and fibrin adhesive in the mucosa-mucosa cleft internally. Ten dogs having combined anastomosis were compared with ten dogs having a two-layer sutured anastomosis in the rectum as a control. The median bursting strength in the rectum seven days after the operation was 280 mm Hg (range, 180 to 340 mm Hg) for the combined anastomosis and 260 mm Hg (range, 170 to 405 mm Hg) for the sutured anastomosis in the control group. Two anastomoses with two-layer sutured anastomosis had a leak demonstrated radiographically, while no leakage was demonstrated in the ten dogs with combined anastomosis. In conclusion, intraluminal applied fibrin adhesive may contribute to the security of the sutured rectum-anastomosis.
Similar content being viewed by others
References
Lembert A. Memoire sur l'entérorphić, avec la discription d'un procéde nouveau pour pratiquer cette opération chirurgicale. Repert Gen Anat Physiol Pathol 1826;2:100–9.
Khubchandani M, Upson JF. Single-layer anastomosis of the colon and rectum. Dis Colon Rectum 1982;25:113–7.
Irvin TT, Goligher JC, Johnston D. A randomized prospective clinical trial of single-layer and two-layer inverting intestinal anastomoses. Br J Surg 1973;60:461–4.
Everett LE, Girotti M, Paloschi G. A comparison of one-layer and two-layer techniques for colorectal anastomoses. Br J Surg 1973;62:135–40.
Goligher JC, Lee PW, Simpkins KC, Lintott DJ. A controlled comparison of one-and two-layer techniques of suture for high and low colorectal anastomoses. Br J Surg 1977;64:609–14.
Brennan SS, Pickford IR, Evans M, Pollack AV. Staples or sutures for colonic anastomoses—a controlled clinical trial. Br J Surg 1982;69:722–4.
McGinn FP. Staples or sutures for low colorectal anastomoses: a prospective randomized trial. Br J Surg 1985;72:603–5.
Nordkild P, Hjortrup A, Kjaergaard J. Tissue adhesives and intestinal anastomosis. Ann Chir Gynaecol 1986;75:205–7.
Schlag G, Redl H, Turnher M, Dinges HP. The importance of fibrin in wound repair. In: Schlag G, Redl H, eds. Fibrin sealant in operative medicine. Berlin: Springer-Verlag, 1963;3:3–12.
Hjortrup A, Nordkild P, Kjaergaard J, Sjøntoft E, Olesen HP. Fibrin adhesive versus sutured anastomosis: a comparative intraindividual study in the small intestine of pigs. Br J Surg 1986;73:760–2.
Kjaergaard J, Nordkild P, Sjontoft E, Hjortrup A. Non-sutured fibrin adhesive versus sutured anastomosis: a comparative intraindividual study in the colon of dogs. Acta Chir Scand 1988;153:599–602.
Nielsen TS, Anders CJ. Dynamics aspects of small intestinal rupture with special consideration of anastomotic strength. Arch Surg 1966;93:309–11.
Nordkild P, Kjaergaard J, Hjortrup A. Healing of fibrin adhesive anastomosis in the small intestine of pigs. Dan Med Bull (in press).
Hawley PR. Causes and prevention of colonic anastomotic break-down. Dis Colon Rectum 1973;16:272–7.
Author information
Authors and Affiliations
About this article
Cite this article
Hjortrup, A., Nordkild, P., Christensen, T. et al. Rectal anastomosis with application of luminal fibrin adhesive in the rectum of dogs. Dis Colon Rectum 32, 422–425 (1989). https://doi.org/10.1007/BF02563696
Issue Date:
DOI: https://doi.org/10.1007/BF02563696