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

• Autor(a) principal: Azevedo, João Luiz Moreira Coutinho [UNIFESP]
• Data de Publicação: 2008
• Outros Autores: Hypólito, Octavio [UNIFESP], Azevedo, Otávio Cansanção [UNIFESP], Becker Jr., Otávio Monteiro [UNIFESP], Freire, Dalmer Faria [UNIFESP]
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• dARK ID: ark:/48912/001300000g20b
• DOI: 10.1590/S0004-28032008000400011
• Texto Completo: http://dx.doi.org/10.1590/S0004-28032008000400011; http://repositorio.unifesp.br/handle/11600/4632
• topic: Anastomosis, surgical; Sutures; Intestine, small; Dogs; Anastomose cirúrgica; Suturas; Intestino delgado; Cães

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.