title: Importance of testing stapled rectal anastomoses with air.
abstract: OBJECTIVE
  To compare the air test (insufflation of air through the anus after the peritoneal cavity has been filled with saline) and the completeness of doughnuts as indicators of the integrity of stapled rectal anastomoses.
  
  
  METHODS
  Prospective open study.
  
  
  METHODS
  Marmara University Hospital, Istanbul, Turkey.
  
  
  METHODS
  23 patients with sigmoid and rectal carcinoma.
  
  
  METHODS
  Correlation between positive air test, completeness of doughnuts, and clinical anastomotic breakdown.
  
  
  RESULTS
  Two patients were withdrawn (one had a handsewn anastomosis and in one the air test was omitted). Five patients had positive air tests, and in four of these the doughnuts were complete. The leaks were repaired with additional sutures in three patients, and two were given covering colostomies. There was only one clinical anastomotic breakdown.
  
  
  CONCLUSIONS
  The air test enabled the surgeon to repair or protect five anastomoses (24%). The completeness of the doughnuts was an reliable test of anastomotic integrity.
authors.affiliation: Marmara University School of Medicine, Department of Surgery, Altunizade, Istanbul, Turkey.
authors.forename: R
authors.initials: R
authors.lastname: Yalin
authors.forename: A O
authors.initials: AO
authors.lastname: Aktan
authors.forename: C
authors.initials: C
authors.lastname: Yeğen
authors.forename: H
authors.initials: H
authors.lastname: Döşlüoğlu
authors.forename: N
authors.initials: N
authors.lastname: Okboy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000388:Air; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D003125:Colostomy; D005260:Female; D006801:Humans; D007327:Insufflation; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000601:surgery; D012007:Rectum / Q000473:pathology / Q000601:surgery*; D012086:Reoperation; D012811:Sigmoid Neoplasms / Q000601:surgery; D013528:Surgical Staplers; D013536:Suture Techniques