Comparison of different techniques of stapled bowel anastomoses in a canine model

M. L. Ritchey, K. P. Lally and R. Ostericher
Department of Surgery, University of Michigan, Ann Arbor.

OBJECTIVE: To evaluate different methods of creating a stapled enteroanastomosis and to determine which method would create a larger anastomosis. DESIGN: Prospective comparison of three groups with a total of 17 mongrel dogs. SETTING: Clinical investigation facility. MAIN OUTCOME MEASURES: Stapled side-to-side enteroanastomoses were created with the stapled edges touching or separated. Anastomoses were created in both functional bowel and in a defunctionalized limb. The anastomotic circumference was measured in a blinded fashion after 28 days. The third group had anastomoses created and measured the same day. Groups were compared using the t test. RESULTS: There was significant narrowing after healing with both types of anastomoses. Anastomoses created by separating the stapled lines were larger than those fashioned with the cut edges touching, both immediately and after healing. CONCLUSIONS: While clinically significant narrowing of a stapled anastomosis is uncommon, separating the staple lines of a functional end-to-end anastomosis may be the preferable method.