Skin stapled bowel anastomosis in a canine model.
OBJECTIVE
The aim of this study is to compare the safety and cost effectiveness of the use of staples designed for skin closure in the construction of colonic anastomoses.


METHODS
Twenty healthy dogs were prospectively randomised to either skin stapled or sutured anastomosis. The ascending colon was transected and reanastomosed. This segment was excised and used to test early bursting strength. There was no significant difference between the two groups. The ends of the colon were reanastomosed.


RESULTS
The time taken to perform the anastomosis and the cost of the suture or staples were noted. The time taken for the stapled anastomosis was significantly faster (p < 0.001) with a mean of 7.95 minutes versus a mean of 23.5 minutes for the handsewn anastomosis. The cost was also significantly less (p = 0.18) with a mean of SGD17.85 compared to a mean of SGD21.15 for the handsewn anastomosis. Two weeks later, the dogs were sacrificed and the late bursting pressures were tested and no significant difference was found between the two groups. The anastomotic site was then sent for histological examination. The four animals, one in the handsewn group and 3 in the skin stapled group, dying prior to sacrifice, were subjected to post-mortem.


CONCLUSIONS
The results show that skin stapled anastomoses are easy to learn and perform and may constitute a viable alternative to hand suture techniques.
Department of Surgery, Tan Tock Seng Hospital, Singapore.
B K
BK
Ang
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D
Cheong
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E
Teh
T A
TA
Teoh
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C
Tsang
D000714:Anastomosis, Surgical / Q000191:economics; D000818:Animals; D003106:Colon / Q000601:surgery*; D003362:Cost-Benefit Analysis; D004285:Dogs; D011897:Random Allocation; D012846:Singapore; D013537:Sutures