Skip to main content
SpringerLink
Log in

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

  • Original Article
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Background and Aims

The objective of this study is to compare the postoperative motility between hand-sewn end-to-end anastomosis and functional end-to-end anastomosis.

Methods

Fifteen conscious dogs were divided into three groups: normal intact dog group, end-to-end anastomosis group (EE), and functional end-to-end anastomosis group (FEE). In the EE and FEE groups, the dogs underwent a transection of the jejunum 30 cm distal to the Treitz ligament and anastomosis in each method. To compare the gastrointestinal motility, the time to the appearance and the rate of propagation of interdigestive migrating motor contractions (IMC) across the anastomosis, as well as the motility index (MI) at the oral and anal sides of the anastomosis, were measured using strain gauge force transducers. Furthermore, the histological examination of intrinsic nerve fibers was evaluated.

Results

The time to the appearance of propagation of IMC in the EE and FEE was not significantly different. The propagation rates of IMC in the EE and FEE completely recovered within 4 weeks of the surgery. The MI in the EE and FEE was not significantly different. In addition, no continuity of intrinsic nerve fibers across the anastomosis could be identified in either group.

Conclusions

In the present study, there are no significant differences between the EE and FEE with regard to the time of the appearance and the rate of propagation of IMC. These results suggest that the effect of functional end-to-end anastomosis on postoperative motility is not different from that of hand-sewn end-to-end anastomosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

Abbreviations

EE:

End-to-end anastomosis group

FEE:

Functional end-to-end anastomosis group

MI:

Motility index

IMC:

Interdigestive migrating motor contractions

PBS:

Phosphate-buffered saline

ANOVA:

Analysis of variance

MMCs:

Migrating myoelectric complexes

References

  1. Steichen FM. The use of staplers in anatomical side-to-side and functional end-to-end enteroanastomoses. Surgery. 1968;64:948–953.

    CAS  PubMed  Google Scholar 

  2. Bluett MK, Healy DA, Kalemeris GC, O’Leary JP. Comparison of automatic staplers in small bowel anastomoses. South Med J. 1986;79:712–716.

    Article  CAS  PubMed  Google Scholar 

  3. Goto T, Kawasaki K, Fujino Y, et al. Evaluation of the mechanical strength and patency of functional end-to-end anastomoses. Surg Endosc. 2007;21:1508–1511.

    Article  CAS  PubMed  Google Scholar 

  4. Arnold JH, Alevizatos CA, Cox SE, Richards WO. Propagation of small bowel migrating motor complex activity fronts varies with anastomosis type. J Surg Res. 1991;51:506–511.

    Article  CAS  PubMed  Google Scholar 

  5. Hocking MP, Carlson RG, Courington KR, Bland KI. Altered motility and bacterial flora after functional end-to-end anastomosis. Surgery. 1990;108:384–391. discussion 391–392.

    CAS  PubMed  Google Scholar 

  6. Sarna S, Condon RE, Cowles V. Enteric mechanisms of initiation of migrating myoelectric complexes in dogs. Gastroenterology. 1983;84:814–822.

    CAS  PubMed  Google Scholar 

  7. Fox DA, Bass P. Selective myenteric neuronal denervation of the rat jejunum. Differential control of the propagation of migrating myoelectric complex and basic electric rhythm. Gastroenterology. 1984;87:572–577.

    CAS  PubMed  Google Scholar 

  8. Sarna S, Stoddard C, Belbeck L, McWade D. Intrinsic nervous control of migrating myoelectric complexes. Am J Physiol. 1981;241:G16–G23.

    CAS  PubMed  Google Scholar 

  9. Sarna SK. Cyclic motor activity; migrating motor complex: 1985. Gastroenterology. 1985;89:894–913.

    CAS  PubMed  Google Scholar 

  10. Behrns KE, Sarr MG, Hanson RB, Zinsmeister AR. Jejunoileal transplantation. Effects on characteristics of canine jejunal motor activity in vivo. Dig Dis Sci. 1996;41:884–893.

    Article  CAS  PubMed  Google Scholar 

  11. Heppell J, Kelly KA, Sarr MG. Neural control of canine small intestinal interdigestive myoelectric complexes. Am J Physiol. 1983;244:G95–G100.

    CAS  PubMed  Google Scholar 

  12. Marik F, Marik F. Control of the interdigestive myoelectric activity in dogs by the vagus nerves and pentagastrin. Gastroenterology. 1975;69:387–395.

    CAS  PubMed  Google Scholar 

  13. Furness J, Costa M, eds. The enteric nervous system. Edinburgh: Churchill Livingstone; 1987.

    Google Scholar 

  14. Sarr MG, Kelly KA. Myoelectric activity of the autotransplanted canine jejunoileum. Gastroenterology. 1981;81:303–310.

    CAS  PubMed  Google Scholar 

  15. Cannon WB, Murphy FT. IV. The movements of the stomach and intestines in some surgical conditions. Ann Surg. 1906;43:512–536.

    Article  CAS  PubMed  Google Scholar 

  16. Nygaard K. Gastro-intestinal motility after resections and bypass-operations on the small intestine in rats. The effect of different types of anastomosis. Acta Chir Scand. 1967;133:653–663.

    CAS  PubMed  Google Scholar 

  17. Miedema BW, Schillie S, Simmons JW, Burgess SV, Liem T, Silver D. Small bowel motility and transit after aortic surgery. J Vasc Surg. 2002;36:19–24.

    Article  PubMed  Google Scholar 

  18. Schippers E, Holscher AH, Bollschweiler E, Siewert JR. Return of interdigestive motor complex after abdominal surgery. End of postoperative ileus? Dig Dis Sci. 1991;36:621–626.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We thank Mr. R. Aoyagi and Ms. M. Saito (Department of Tumor Pathology, Gunma University Graduate School of Medicine) for their excellent technical assistance.

Author information

Authors and Affiliations

  1. Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan

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

Authors
  1. Yoshitaka Toyomasu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Erito Mochiki
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hiroyuki Ando
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mitsuhiro Yanai
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kyoichi Ogata
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yuichi Tabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Tetsuro Ohno
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ryuusuke Aihara
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Hiroyuki Kuwano
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yoshitaka Toyomasu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Toyomasu, Y., Mochiki, E., Ando, H. et al. Comparison of Postoperative Motility in Hand-Sewn End-to-End Anastomosis and Functional End-to-End Anastomosis: An Experimental Study in Conscious Dogs. Dig Dis Sci 55, 2489–2497 (2010). https://doi.org/10.1007/s10620-009-1040-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-009-1040-9

Keywords

Search

Navigation