Abstract
A disturbance in blood flow in the gastrointestinal anastomosis can be considered as one of the causes of incomplete suture which is one of the postanastomosis complications. In order to determine the relationship between blood flow and incomplete suture, manual and stapled anastomosis were performed in adult mongrel dogs, and then measurement of tissue blood flow by the hydrogen clearance method, pathological examinations of tissues and pressure test were performed. The amount of blood flow in the manual anastomosis at 7 days after surgery was increased to 79.6±15.3 ml/min/100 g in compared with the values obtained immediately after surgery, while blood flow in the stapled anastomosis was 52.3±15.6 ml/min/100 g. Incomplete suture occurred in 2 of 10 manual anastomosis and 1 of 10 stapled anastomosis, and the frequency of incomplete suture was lower in case of stapled anastomosis even though the blood flow was less than 40 ml/min/100 g. Esophageal reconstruction had been performed on 234 patients at our department, and incomplete suture occurred in 24 of 91 cases of manual anastomosis (about 26.4%) and in 15 of 143 cases of stapled anastomosis (about 10.5%) . The frequency of stump disruption was also lower with stapled anastomosis in clinical materials.
