Influence of staple line number and configuration on the leakage of small intestinal functional end‐to‐end stapled anastomosis: An ex vivo study

• Published in: Veterinary surgery 2022-07, Vol.51 (5), p.781-787
• Main Authors: Quitzan, Juliany Gomes, Singh, Ameet, Beaufrère, Hugues, Saleh, Tarek M.
• Format: Article
• Language: English
• Subjects: Anastomosis; Cadavers; Configurations; Intestine; Leakage; Population studies; Segments; Staples
• ISSN: 0161-3499; 1532-950X
• DOI: 10.1111/vsu.13818

Objective To determine the influence of the staple line configuration on the leakage of small intestinal functional end‐to‐end stapled anastomosis (FEESA). Study design Experimental, ex vivo, randomized study. Sample population Jejunal segments (N = 72) from 10 mature, canine cadavers. Methods Jejunal segments (10 cm) were randomly assigned to a control group (8 segments) and 4 FEESA groups (16 segments/group (8 constructs/group)), according to the number of rows of staples used in the vertical (V) and transverse lines (T), respectively: Control, 2‐row V/2‐row T (2V/2T), 2‐row V/3‐row T (2V/3T), 3‐row V/2‐row T (3V/2T), 3‐row V/3‐row T (3V/3T). Initial leak pressure (ILP), maximum intraluminal pressure (MIP), and initial leakage location (ILL) were compared. Results The ILP (mean ± SD) for control segments, 2V/2T, 2V/3T, 3V/2T and 3V/3T were 321.38 ± 34.59, 32.88 ± 7.36, 50.13 ± 10.46, 34.38 ± 11.78, 69.88 ± 21.23 mmHg, respectively. All FEESAs initially leaked at lower pressures than intact segments. The only other differences detected between groups consisted of ILPs that were higher when FEESAs were closed with 3V/3T (69.88 ± 21.23 mmHg) than 2V/2T (32.88 ± 7.36, P