Management of a high-risk intestinal anastomosis

An experimental model was utilized to evaluate and compare the function of an exteriorized intestinal anastomosis and an intraperitoneal anastomosis in sixteen animals. No anastomotic leakage occurred and no difference was noted in the microscopic appearance, function, and strength of the anastomoses at seven days. Return of the exteriorized anastomosis to the peritoneal cavity did not result in significant late complications. This technic was then utilized in managing thirty animals with obstructed colons. Sixty-seven per cent of these animals had healing of exteriorized anastomosis; those anastomoses which leaked (33 per cent) were converted to colostomies. No intraperitoneal contamination resulted from leakage of an exteriorized anastomosis.