[Colonic vascularization does not change by circular stapling: an angiographic study in dogs]

Anastomotic devascularization has been incriminated in the development of post-operative complications (fistula, stenosis) of circular stapling. The effect of circular stapling on left colonic blood supply in dogs has been evaluated. Twelve transanal colonic transsections (ILS 29 or 33), were performed at the level of the inferior mesenteric artery in 12 dogs, then examined at different post-operative times, after injection by barium sulfate and radiography. In group I (D1, D3, D7) the entire mesocolon was injected, in group II (D7, D12, D15), only the supra-anastomotic part was injected. In group I, there was no alteration in blood flow at the anastomotic margins. The vascular pattern at the site of anastomosis was similar to that observed in the normal colon. In group II, good blood supply was confirmed and no capillary cross-bridging was found at this early healing time. This study limits the role of anastomotic devascularization by staplers in the development of secondary complications of circular stapling. If such a devascularization has to be accused, it is more likely the consequence of the surgical technique than of the stapler "per se".