[A perspective study on blood flow of the gastrointestinal anastomosis with special reference to the influence on blood flow at the anastomotic region by the suture material and it's size and the suturing interval].
To investigate the change of blood flow of the gastrointestinal anastomotic site by the material of the suture, the size of suture, the suture interval, blood flow, microangiography and histology of the anastomosis including tissue reaction were examined. Results are as follows. 1. When the colonic anastomosis was devascularized, the anastomotic blood flow was significantly lower and the avascular area in microangiography was significantly larger in the case of the silk and the 2mm suturing interval group compared to those of the polyglycolic acid (PGA) and the 4mm group. Concerning the size, the 4-0 group and the 6-0 group did not show any difference. 2. The necrotic change of the tissue surrounded by the suture was observed in 42.9% in the 4mm interval group and in 75.0% in the 2mm group. 3. The areas of the extension of tissue reaction to the suture were wider in the silk group than those of the PGA group. In conclusion, blood circulation of the anastomosis is affected by the material of the suture as well as by the suture interval, and under an insufficient blood flow, the use of the suture with lesser tissue reaction is preferable, and the suture interval should be kept at 4mm.
Second Department of Surgery, Juntendo University, Tokyo, Japan.
K
K
Ohashi
D000714:Anastomosis, Surgical; D000818:Animals; D004064:Digestive System / Q000098:blood supply*; D013505:Digestive System Surgical Procedures; D004285:Dogs; D005260:Female; D019476:Insect Proteins; D008297:Male; D008833:Microcirculation; D011100:Polyglycolic Acid; D011506:Proteins; D012039:Regional Blood Flow; D047011:Silk; D013537:Sutures
D019476:Insect Proteins; D011506:Proteins; D047011:Silk; D011100:Polyglycolic Acid