Importance of testing stapled rectal anastomoses with air.
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Two patients were withdrawn (one had a handsewn anastomosis and in one the air test was omitted).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.
Yalin
R
R
Marmara University School of Medicine, Department of Surgery, Altunizade, Istanbul, Turkey.
Aktan
A O
AO
Yeğen
C
C
Döşlüoğlu
H
H
Okboy
N
N
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