An experimental comparison of inversion and eversion colonic anastomoses

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Abstract
Summary and Conclusions The inverting, double-layer anastomosis required more time than the single-layer eversion. No significant difference in the degrees of inflammation after inversions and eversions was observed on microscopic examination. The degree of adhesion formation adjacent to the anastomoses was not appreciably different in the two types. Healing by restoration of mucosal continuity and fibroplasia appeared earlier in inversions than in eversions. Reduction of the lumen was greater by inversion, especially in the early postoperative period. Resistance to disruption by distention in inversions was greater than it was in eversions. However, after a lapse of nine days, eversions had adequate resistance to disruption. Local complications were less common after inversions than after eversions and the mortality rate after the former was appreciably lower than that after the latter. Adequate cleansing of the colon appeared to exert a favorable influence on inversion repair. Although the standard double-layer inversion technic of colonic anastomosis caused more stenosis, it resisted disruption better, caused fewer local complications and had a lower mortality rate than the single-layer eversion anastomosis.