Clinical and experimental background for new method of bowel anastomosis

Aim. To improve the results of bowel resection using newly designed bowel anasthomosis method. Methods. A new method of forming enteroenteroanastomosis was proposed and developed, based on calculating the vitality index for suture strip, arterial blood hemoglobin saturation and microcirculation after preparing the suture strip. After that, holder sutures are overcast at the preserved major vessel at mesenteric and counter-mesenteric edges of suture strips of efferent and afferent bowels. A running sero-muscular suture is formed between the edges, followed by 1-2 nodal sero-muscular side sutures and invagination of suture strips to the efferent loop. After that, a running sero-muscular suture is formed on the front of the anastomosis. Results. Pre-clinical testing was performed on 40 dogs, with no cases of anastomosis leak. Clinical testing included 30 patients who underwent colectomy. Enteroenteroanastomosis was formed by the proposed method, preceded by suture strip microcirculation examination. In patients of the control group who underwent colectomy, enteroenteroanastomosis was formed by classical double-row suture without examining suture strip microcirculation. No cases of anastomosis leak were registered in the main group, compared to 4 cases in the control group. Conclusion. Clinical and experimental studies have shown the effectiveness of the developed enteroenteroanastomosis.

colectomy, experimental study, intestinal anastomosis, enteroenteroanastomosis, anastomosis leak