A comparison of stapled and hand-sewn colonic anastomoses

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Abstract
The purpose of this study of the dog colon was to compare the one-layer inverted and the one-layer everted, hand-sutured anastomoses with the everted stapled anastomosis. In order to determine small differences in suture techniques, anastomoses must be subject to nonphysiologic stresses. Critical experimental evaluation of the stapled anastomosis indicates that it is not as secure as the inverted one-layer anastomosis. The clinical application of this observation may be that the everted stapling method should not be used in an extraperitoneal anastomosis or in the presence of adverse conditions such as infection, radiation enteritis, or inflammatory bowel disease.

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