Comparative study of hand sewn single layer anastomosis of dog's bowel

• Autor(a) principal: Azevedo,João Luiz Moreira Coutinho
• Data de Publicação: 2008
• Outros Autores: Hypólito,Octávio, Azevedo,Otávio Cansanção, Becker Jr.,Otávio Monteiro, Freire,Dalmer Faria
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Arquivos de gastroenterologia (Online)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032008000400011
• topic: Anastomosis, surgical; Sutures; Intestine, small/surgery; Dogs

BACKGROUND: Two-layer intestinal anastomosis increases the inflammatory response while single-layer anastomosis results in a better wound healing. However the four main kinds of stitches which may be chosen in performing single layer intestinal sutures never before had been comparatively studied. AIM: To compare the four more commonly used types of single layer surgical anastomosis sutures of the digestive tract. METHODS: Six mongrel dogs were operated, each one receiving two anastomosis: one at 30 cm from de Treitz angle - sero-submucosal technique, and the other at 60 cm - total technique. This placement was alternatively inverted. The four more commonly used types of single layer surgical anastomosis sutures of the digestive tract, namely: sero-submucosal stitches tied in the lumen, over the submucosa; sero-submucosal stitches tied in the exterior of the organ, over the serosa; total stitches tied in the lumen, over the mucosa; and total sutures tied in the exterior, over the serosa (Gambee's stitches) were tested. After euthanasia (7th post-operative day) macro and microscopic features were evaluated. Friedman's test was applied for morphometry and for evaluation of the peritoneal adhesions. RESULTS: Statistical significance was demonstrated through major residual acute inflammation and proliferation in total sutures and more profuse adhesions with the sero-submucosal stitches tied in the lumen. The sero-submucosal stitches tied in the exterior over the serosa, had excellent realignment and regeneration of the layers. CONCLUSION: The sero-submucosal stitches tied in the exterior, over the serosa, were the best ones.