Ex Vivo and Simulation Comparison of Leakage in End-to-End Versus End-to-Side Anastomosed Porcine Large Intestine
Youssef Fahmy, Mohamed Trabia, Brian Ward, Lucas Gallup, Whitney Elks
TL;DR
This study compares two surgical techniques for connecting intestines and finds that one method may reduce the risk of leaks during colorectal surgery.
Contribution
A novel experimental setup and finite element simulation were used to compare anastomotic techniques ex vivo.
Findings
End-to-side anastomoses showed longer time to leakage compared to end-to-end and control specimens.
Finite element simulations successfully modeled the ex vivo experiments.
End-to-side anastomoses performed better in tissue expansion and stress-strain metrics.
Abstract
Anastomotic leaks after colorectal resection are serious surgical complications. We have compared the integrity of two common colorectal anastomosis techniques, end-to-side (ES) and end-to-end (EE), to control specimens using a novel experimental setup that mimics anastomotic air leak tests, which are typically performed during surgeries. Freshly harvested porcine colonic sections from 23 F1 cross-species pigs were used. Pressure measurements and video imaging were used to monitor the ex vivo experiments on EE, ES, and Control specimens. Using EE (n = 16), ES (n = 12), and Control (n = 22) specimens, leak pressure was 282.6 ± 3.0 mm Hg for EE, 282.8 ± 2.6 mm Hg for ES, and 294.4 ± 12.1 for the Control. Time to leakage was 106.3 ± 28.1 s for EE, 263.9 ± 2127.0 s for ES, and 194.5 ± 90.2 s for the Control. We found that, while EE and ES have nearly identical leak pressures, ES was…
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Taxonomy
TopicsColorectal Cancer Surgical Treatments · Abdominal Surgery and Complications · Cardiac, Anesthesia and Surgical Outcomes