By R. Gullichsen (auth.), Prof. Dr. Rainer Engemann, Prof. Dr. med. A. Thiede (eds.)
Biofragmentable anastomoses earrings characterize a desirable proposal: Stan dardization of anastomoses, safe strategy in software, expulsion of the fabric with out residuals. furthermore, one unmarried strategy permits to accomplish the classical finish to finish, finish to aspect, and aspect to facet anastomoses in such a lot components of the gastrointestinal tract, with none auxiliary device. this suggests a superb good thing about practicability. managed experiences evidenced that the speed of issues is particularly small for the intestinal tract. as a result, you will need to identify the localization for current indication and contra symptoms. chapters in particular take care of higher GI anastomoses in cluding esophagus anastomoses and with BAR anastomoses in inflammatory bowel sickness. this can be performed by way of analysing the knowledge and via an trade of expertise among the medical study teams. This publication is to communi cate experimental info and to extend figuring out approximately pathophysiology of the therapeutic of anastomoses through compression anastomoses. Wiirzburg, Germany, Prof. Dr. R. ENGEMANN October 1994 Prof. Dr. A. THIEDE Contents Experimental examine Histological and medical features of Early therapeutic of the Valtrac Anastomosis within the Colon R. GULLICHSEN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . three Colorectal Intramural Blood provide and Microcirculation in guy M. A. R. AL FALLOUJI (With five Figures) . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Biofragmentable Anastomosis Ring as opposed to Stapled Anastomoses within the Extraperitoneal Rectum: Experimental examine in canine N. G. CZECZKO, B. POLONIO, L. F. COLA
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A) Near to the trachea? b) Distal to the tracheal bifurcation? 10. What about the future perspectives, based upon the present data, for the clinical application of the BAR in the esophagus? Material and Methods Fifty-six mongrel dogs, weighing 8-14 kg, were studied in two groups: the BAR group (n = 28) and the hand-sewn group (n = 28). v. sodic thiopental in a dose of 25 mg/kg bodyweight. v. as prophylaxis. The procedure in the hand-sewn group was an esophageal transection and an extramucous interrupted hand-sewn anastomosis with monofilament polyglyconate 4/0 (Maxon, Davis and Geck) with an atraumatic T-31 (17mm) needle.
The bowel was prepared as described by Polonio et al. . The dogs received a liquid diet for 3 days prior to the procedure; 48 h before surgery a rectocolonic enema was performed and repeated 4 h before the surgery. This bowel preparation was complemented with a watery cleansing after narcosis. The animals fasted for 12 h prior to surgery. v. v. as a prophilaxis in a single dose. Surgical Procedure The procedures for the animals in the stapler group were as follows: left paramedian incision, examination of the peritoneal cavity, cystostomy, section of the peritoneal reflection at the level of the low rectum, section of the rectum with cauterization of the submucosal vessels, and resection of a 5-cm colorectal segment; construction of a purse-string at the colonic and rectal extremities with monofilament nylon (by hand); anal dilation, introduction of ILS, closing the stapler to the 2-mm mark, and stapling.
Statistical Evaluation The results of both groups were compared by the X2 test, assuming a normal distribution. If dal > iab, the differences between the groups were considered significant. For the comparison of the means the Student's t test was used; for -ttab < tcal < ttab it was assumed that there is no significant difference between groups. , purse-string suture rupture and a mistaken choice of the BAR size) were easily corrected. , vomiting, choking, or coughing) in three animals in the hand-sewn group and seven animals of the BAR group.