A comparison of circular stapling devices for rectal anastomoses

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Abstract
Mechanical circular stapling devices offer several advantages in the formation of low rectal anastomoses. The quality of rectal anastomoses created in dogs using the 2 commonly available staple suture guns, the EEA [end-to-end anastomotic] and SPTU was compared. Thirty dogs, 15 with each gun, had rectal division and anastomosis. The first 20 dogs (10 EEA and 10 SPTU) were sacrificed at 8 days. Anastomotic integrity was assessed using plain X-ray, Ba enema and postmortem examination and pressure studies. The remaining 10 dogs, 5 in each group, were sacrificed at 48 h and the anastomoses were inspected and examined histologically. Eleven of 15 anastomoses in the EEA group showed evidence of breakdown compared with only 3 of 15 in the SPTU group (P < 0.01). The SPTU gun created a more satisfactory anastomosis and this was probably due to its staples having an adjustable closure.