Intraluminal pressure adjacent to left colonic anastomoses.
A cumulative total of 89 h of pressure data was acquired from both sides of a left colonic anastomosis in 15 patients over a median period of 7 postoperative study days. Patients had a colonic ileus lasting 3-10 days and during this proximal and distal inactivity the intraluminal pressure remained within 6 mmHg of atmospheric pressure. After recovery of activity, pressures proximal to the anastomosis in excess of 10 mmHg occurred during less than 1 per cent of the recording time. Distal peak pressures were significantly elevated with respect to the proximal site (P less than 0.001). Two-thirds of the distal pressures recorded were between 10 and 20 mmHg and 98 per cent were less than 50 mmHg; the peak distal pressure was 90 mmHg. Four patients had distal repetitive tonic contractions creating a pressure difference across the anastomosis with a mean of 20 mmHg and a peak of 45 mmHg. Each contraction persisted for 15-20 min. Intraluminal pressures are unlikely to play a role in anastomotic dehiscence.
Burkitt
D S
DS
Dudley Road Hospital, Birmingham, UK.
Donovan
I A
IA
D000714:Anastomosis, Surgical; D003106:Colon / Q000503:physiopathology*; D003108:Colonic Diseases / Q000503:physiopathology; D015179:Colorectal Neoplasms / Q000601:surgery*; D005769:Gastrointestinal Motility / Q000502:physiology; D006801:Humans; D007418:Intestinal Pseudo-Obstruction / Q000503:physiopathology; D011183:Postoperative Complications / Q000503:physiopathology; D011312:Pressure; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013997:Time Factors