Analysis of techniques and results in 347 consecutive colon anastomoses

Steven A. Curley, David C. Allison, Daniel E. Smith, Raymond C. Doberneck

Research output: Contribution to journalArticle

Abstract

We have reported our experience with 347 consecutive colon anastomoses in 321 patients seen over an 8 year period. The overall anastomotic failure, mortality, and complication rates were 1.4, 2, and 10 percent, respectively, for the entire series. The complication and death rates were significantly higher in patients whose anastomoses were completed as part of an emergency procedure. Even though various one- and two-layer inverting techniques, suture materials, and staples were used, we could not identify any one method as being clearly superior in preventing anastomotic complications, although the results do suggest that some caution may be appropriate before mechanical stapling devices are universally applied. The results support that adherence to accepted surgical principles of reducing the solid content and fecal flora of the colon prior to operation, insuring an excellent blood supply to both bowel ends, even approximation of the bowel ends with inverting sutures which include the submucosal layer of the bowel, absence of tension, meticulous hemostasis, and avoidance of anastomosis in the presence of peritonitis are the primary means of avoiding dehiscence of colon anastomoses.

Original languageEnglish (US)
Pages (from-to)597-601
Number of pages5
JournalAmerican Journal of Surgery
Volume155
Issue number4
DOIs
StatePublished - 1988
Externally publishedYes

Fingerprint

Colon
Suture Techniques
Mortality
Hemostasis
Peritonitis
Sutures
Emergencies
Equipment and Supplies

ASJC Scopus subject areas

  • Surgery

Cite this

Analysis of techniques and results in 347 consecutive colon anastomoses. / Curley, Steven A.; Allison, David C.; Smith, Daniel E.; Doberneck, Raymond C.

In: American Journal of Surgery, Vol. 155, No. 4, 1988, p. 597-601.

Research output: Contribution to journalArticle

Curley, Steven A. ; Allison, David C. ; Smith, Daniel E. ; Doberneck, Raymond C. / Analysis of techniques and results in 347 consecutive colon anastomoses. In: American Journal of Surgery. 1988 ; Vol. 155, No. 4. pp. 597-601.
@article{a6c804fc51a64f3aaf7980fdb8386793,
title = "Analysis of techniques and results in 347 consecutive colon anastomoses",
abstract = "We have reported our experience with 347 consecutive colon anastomoses in 321 patients seen over an 8 year period. The overall anastomotic failure, mortality, and complication rates were 1.4, 2, and 10 percent, respectively, for the entire series. The complication and death rates were significantly higher in patients whose anastomoses were completed as part of an emergency procedure. Even though various one- and two-layer inverting techniques, suture materials, and staples were used, we could not identify any one method as being clearly superior in preventing anastomotic complications, although the results do suggest that some caution may be appropriate before mechanical stapling devices are universally applied. The results support that adherence to accepted surgical principles of reducing the solid content and fecal flora of the colon prior to operation, insuring an excellent blood supply to both bowel ends, even approximation of the bowel ends with inverting sutures which include the submucosal layer of the bowel, absence of tension, meticulous hemostasis, and avoidance of anastomosis in the presence of peritonitis are the primary means of avoiding dehiscence of colon anastomoses.",
author = "Curley, {Steven A.} and Allison, {David C.} and Smith, {Daniel E.} and Doberneck, {Raymond C.}",
year = "1988",
doi = "10.1016/S0002-9610(88)80417-3",
language = "English (US)",
volume = "155",
pages = "597--601",
journal = "American Journal of Surgery",
issn = "0002-9610",
publisher = "Elsevier Inc.",
number = "4",

}

TY - JOUR

T1 - Analysis of techniques and results in 347 consecutive colon anastomoses

AU - Curley, Steven A.

AU - Allison, David C.

AU - Smith, Daniel E.

AU - Doberneck, Raymond C.

PY - 1988

Y1 - 1988

N2 - We have reported our experience with 347 consecutive colon anastomoses in 321 patients seen over an 8 year period. The overall anastomotic failure, mortality, and complication rates were 1.4, 2, and 10 percent, respectively, for the entire series. The complication and death rates were significantly higher in patients whose anastomoses were completed as part of an emergency procedure. Even though various one- and two-layer inverting techniques, suture materials, and staples were used, we could not identify any one method as being clearly superior in preventing anastomotic complications, although the results do suggest that some caution may be appropriate before mechanical stapling devices are universally applied. The results support that adherence to accepted surgical principles of reducing the solid content and fecal flora of the colon prior to operation, insuring an excellent blood supply to both bowel ends, even approximation of the bowel ends with inverting sutures which include the submucosal layer of the bowel, absence of tension, meticulous hemostasis, and avoidance of anastomosis in the presence of peritonitis are the primary means of avoiding dehiscence of colon anastomoses.

AB - We have reported our experience with 347 consecutive colon anastomoses in 321 patients seen over an 8 year period. The overall anastomotic failure, mortality, and complication rates were 1.4, 2, and 10 percent, respectively, for the entire series. The complication and death rates were significantly higher in patients whose anastomoses were completed as part of an emergency procedure. Even though various one- and two-layer inverting techniques, suture materials, and staples were used, we could not identify any one method as being clearly superior in preventing anastomotic complications, although the results do suggest that some caution may be appropriate before mechanical stapling devices are universally applied. The results support that adherence to accepted surgical principles of reducing the solid content and fecal flora of the colon prior to operation, insuring an excellent blood supply to both bowel ends, even approximation of the bowel ends with inverting sutures which include the submucosal layer of the bowel, absence of tension, meticulous hemostasis, and avoidance of anastomosis in the presence of peritonitis are the primary means of avoiding dehiscence of colon anastomoses.

UR - http://www.scopus.com/inward/record.url?scp=0023939317&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023939317&partnerID=8YFLogxK

U2 - 10.1016/S0002-9610(88)80417-3

DO - 10.1016/S0002-9610(88)80417-3

M3 - Article

C2 - 3354785

AN - SCOPUS:0023939317

VL - 155

SP - 597

EP - 601

JO - American Journal of Surgery

JF - American Journal of Surgery

SN - 0002-9610

IS - 4

ER -