By B. Lünstedt, R. Engemann, S. Debus, L. Lim, A. Thiede (auth.), Prof. Dr. med. Rainer Engemann, Prof. Dr. med. Arnulf Thiede (eds.)
The anastomotic approach performs a primary position in gastrointestinal surgical procedure. A feared problem is leakage as a result of the sutures. Such leakage can't be detected early; as a result, an infection spreads in the community and systemically. An anastomotic process is mostly evaluated based on its cost of leakage, with regards to the localization, bur actual clinical comparisons, i.e., managed stories, are nearly absolutely lack ing. the factors of review contain the kind of suture, the localization, the auxiliary technical instruments, practicability, different different types of wound therapeutic, angiogenesis, and vascularization, between others. The postoperative standards are issues almost immediately after surgical procedure, reminiscent of bleeding, ruptures, and stenoses of the anastomosis. a customary comparability is made tough via the range of cytophysiological and biochemical components that effect wound therapeutic. within the comparability of bigger sequence one should always keep in mind adjustments of auxiliary instruments, suggestions, and inhomogeneity of sufferers. a metamorphosis of 1 auxiliary software or of 1 method implies the amendment of assorted objective standards. usually adequate, although, one doesn't sufficiently reflect on the surgeon's such a lot. very important role.
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Extra info for Intestinal Anastomoses with Bioabsorbable Anastomosis Rings: Proceedings of the First European Workshop
5. Tilting of the anastomotic ring in the sigmoid Tilting of the Bioabsorbable Ring Optimal for the healing process is the even distribution of tension at the intestine ends with the anastomosis rings: The axis of the anastomosis rings should lie parallel to the lumen axis of the intestine. Asymmetric tension forces a tilting of the ring, which generates asymmetrically high tension forces at individual points in the case of a stronger tilt and induces an obstruction of the intestinal passage (Fig.
Leakages The most significant postoperative complication after intestinal anastomoses is anastomotic leakage. Rates vary depending on the site of anastomosis. In the first clinical application by the inventor himself (Hardyet al. 1987), there was a rate of 0% (0/27). The multicenter trials report a rate of 3%, with no significant difference from the stapled or control groups (Bubrick et al. 1991). 9% (21101), representing no difference from the stapled or hand-sewn controls (9). Our own results show a clinically 48 R.
1989). In 4% of the cases the problem was resolved. 9% of cases (n = 9). The principal problems were that the device was too large to enter the intestine, a serosal tear occurred, and the intestinal wall was too thick to be placed in between the 6-mm open gap or to close it. 6%) due to our having chosen the wrong gap size at the compression zone. In three instances the ring diameter was not adequate (1 %) and the ring had to be exchanged. 3%), all of which were corrected. 9%. In 53 instances, an additional suture was necessary to correct either the pursestring suture or the anastomosis.
Intestinal Anastomoses with Bioabsorbable Anastomosis Rings: Proceedings of the First European Workshop by B. Lünstedt, R. Engemann, S. Debus, L. Lim, A. Thiede (auth.), Prof. Dr. med. Rainer Engemann, Prof. Dr. med. Arnulf Thiede (eds.)