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In-continuity gastrointestinal stapling.

M W Mulholland, F Magallanes, T M Quigley

    Diseases of the Colon and Rectum
    |September 1, 1983
    PubMed
    Summary
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    Surgical stapling to close the gut without cutting (incontinuity stapling) failed in dogs, with most staple lines breaking down within two weeks. This indicates stapled closures are unreliable for gastrointestinal surgery, especially in the colon and small intestine.

    Area of Science:

    • Gastrointestinal Surgery
    • Surgical Innovation
    • Histopathology

    Background:

    • Surgical staplers offer a method to create gastrointestinal continuity without transection.
    • Investigating the efficacy of incontinuity stapling in different segments of the canine gastrointestinal tract is crucial for surgical practice.

    Purpose of the Study:

    • To evaluate the functional and histologic outcomes of incontinuity stapling in the canine gastric antrum, small intestine, and colon.
    • To determine the failure rate and timing of staple line disruptions in these organs.

    Main Methods:

    • End antrostomy, ileostomy, and colostomy were created in dogs.
    • Incontinuity staple lines (TA 55-4.8 mm staples) were placed proximal to the stoma.
    • Enteric anastomosis was performed for decompression; staple line integrity was monitored by stoma leakage.

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    Main Results:

    • Gastric antrum staple lines failed in 3 of 5 dogs (mean 19.6 days).
    • Small intestine staple lines failed in all 5 dogs (mean 12.4 days).
    • Colonic staple lines failed in all 5 dogs (mean 13.0 days); staples pulled through the bowel wall without submucosal healing.

    Conclusions:

    • Incontinuity stapling in the canine colon and small intestine demonstrates a high failure rate, disrupting around two weeks post-operation.
    • Lack of submucosa-to-submucosa healing contributes to staple line failure.
    • Gastric antrum stapling also shows a tendency to disrupt, though less consistently than in the intestines.