The healing of single- and double-row stapled circular anastomoses

The healing of anastomoses performed by single- or double-row circular stapling instruments is analyzed in the dog colon. Mucosal healing is better in single-row stapled anastomoses. Apposition of the outer intestinal layers is superior in double-row stapled anastomoses. Bursting pressure and circular wall tension values are identical in both anastomotic types except at 24 hours after surgery when the strength of a double-row stapled anastomosis is superior. A cost-benefit analysis is still in favor of single-row circular instruments. In our opinion, adequate preoperative bowel preparation and a thorough surgical technique, when preparing the cut edges to be anastomosed and placing purse-string sutures, are infinitely more important than making a choice between single- or double-row stapling machines.