Low anterior anastomotic dehiscence following preoperative irradiation with 6000 rads

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Abstract
Twenty mongrel dogs received 6000 rads of irradiation to the rectum and colon using the Nominal Standard Dosage Equation. Three weeks after irradiation each dog underwent anterior resection of the rectosigmoid with reconstruction randomized to either an EEA [end-to-end anastomotic] stapled or a 2 layer handsewn anastomosis. Each dog was studied digitally and by Ba enema at the time of surgery, on the 7th postoperative day and at autopsy. Five clinically significant leaks and 3 radiographic leaks occurred in the EEA stapled anastomoses. The handsewn anastomoses had 5 clinically significant leaks and 2 radiographic leaks. Low anterior resection with either an EEA stapled or handsewn anastomosis cannot be done safely after 6000 rad preoperative irradiation.