A comparative radiographic study of low anterior colon anastomoses in dogs

A radiographic animal study comparing two-layer and hand-sewn colorectal anastomoses to anastomoses made with an inverting circular stapling device revealed a highly significant difference in anastomotic leak rate: 13 anastomotic dehiscences were demonstrated in 20 dogs with hand-sewn anastomosis (65%), and four leaks (20%) were found in 20 dogs with stapled anastomoses. All leaks occurred between the third and seventh postoperative days and most were not clinically significant. A marginally significant difference in mortality rate was found, with four deaths among the hand-sewn group (20%) and two among the stapled group (10%). The data suggest that the EEA stapling device may be preferable to hand-sewn techniques, particularly for low extraperitoneal colorectal anastomoses.