Bowel anastomosis by inverting and everting techniques. An experimental study |
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| Authors: | J E Healey C M McBride H S Gallager |
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| Affiliation: | 1. Departments of Surgery and Pathology, The University of Texas, Austin, Tex. USA;2. M. D. Anderson Hospital and Tumor Institute, Houston, Tex. USA;1. Schulich School of Medicine and Dentistry: Western University Schulich School of Medicine & Dentistry, London ON, N6A 5C1, Canada;2. Schulich School of Medicine and Dentistry: Western University Schulich School of Medicine & Dentistry, Department of Surgery and Pediatrics, Division of Urology, London ON, N6A 5W9, Canada;1. Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq;2. Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq;3. College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq;1. Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel;2. Genetics Institute, Meir Medical Center, Kfar Saba, Israel;3. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel;1. Division of Breast Surgery, European Institute of Oncology, Via G. Ripamonti 435, 20141 Milan, Italy;2. Division of Epidemiology and Biostatistics, European Institute of Oncology, Via G. Ripamonti 435, 20141 Milan, Italy;3. Physiotherapy Service, European Institute of Oncology, Via G. Ripamonti 435, 20141 Milan, Italy;4. European Institute of Oncology, Via G. Ripamonti 435, 20141 Milan, Italy;5. University of Milan, European Institute of Oncology, Via G. Ripamonti 435, 20141 Milan, Italy;6. Division of Breast Radiology, European Institute of Oncology, Via G. Ripamonti 435, 20141 Milan, Italy;7. Department of Pathology and Laboratory Medicine, European Institute of Oncology, Via G. Ripamonti 435, 20141 Milan, Italy;8. Scientific Directorate, European Institute of Oncology, Via G. Ripamonti 435, 20141 Milan, Italy;1. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Geisinger Medical Center, Danville, PA;2. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA;1. Third-year Medical Student, Oakland University William Beaumont School of Medicine, USA;2. Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, USA |
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| Abstract: | In this experimental study the surgical dictum that it is necessary to coapt serosa-to-serosa in order to obtain intestinal healing is challenged. A control group of large and small bowel anastomoses is compared with experimental groups in which direct submucosal apposition and everting techniques both by suture and nonsuture reapproximation of bowel are performed. Primary healing was obtained in all groups. Histologically a similar reaction was observed whether the anastomosis was by inversion, submucosal apposition, or everting techniques. Of significance was the low morbidity rate in the animals in which the bowel anastomoses were everted. The rate of morbidity is low probably because the intestinal lumen is not narrowed at the anastomotic site. From the results of this study Halsted's principle of including the submucosal layer in the bowel closure is much more important in intestinal healing than is Lembert's dictum of serosa-to-serosa approximation. |
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