title: Compression Anastomosis Clips Versus a Hand-Sewn Technique for Intestinal Anastomosis in Pigs.
abstract: BACKGROUND
  Anastomotic dehiscence and leaks are major problems in gastrointestinal surgery and result in increased morbidity and mortality. The ideal device to create anastomoses should ensure good serosal apposition without requiring either transgression of the bowel wall or the presence of foreign material for an extended period of time.
  
  
  OBJECTIVE
  The aim of this experimental study was to evaluate the safety and efficacy of a new compression anastomosis clip (CAC) for jejunojejunostomies and ileocolostomies by comparing CAC anastomoses with hand-sewn (HS) anastomoses in pigs in terms of healing, breaking strength and the time to create anastomoses.
  
  
  METHODS
  The 11 pigs in the study underwent side-to-side CAC and HS jejunojejunostomies and ileocolostomies, for a total of 88 anastomoses. The pigs were sacrificed on postoperative day 5 (5 pigs) or 7 (6 pigs). Macroscopic, histopathological and breaking-strength examinations were performed. The time to create the anastomoses was recorded.
  
  
  RESULTS
  Neither group had anastomotic complications such as leakage or obstruction. Macroscopic examination showed no statistically significant differences between the groups. In the CAC group, the healing process was characterized by a lesser inflammatory reaction (p < 0.05) and very thin scar tissue at the anastomotic line (less collagen deposition and better epithelial regeneration), while the HS group had a much thicker anastomotic line. The breaking strength was significantly greater in the CAC group compared with the HS group (p < 0.05). The anastomosis time was shorter in the CAC group than in the HS group (p < 0.01).
  
  
  CONCLUSIONS
  Anastomosis using a CAC appears to be safe and less time-consuming than HS; it was also characterized by a good healing process with little inflammatory reaction and a high breaking strength compared with HS anastomosis.
authors.affiliation: Department of Gastrointestinal Surgery, Medical University of Silesia, Katowice, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Kuśnierz
authors.affiliation: Department of Pathomorphology, Medical University of Silesia, Katowice, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Kajor
authors.affiliation: Department of Gastrointestinal Surgery, Central Teaching Hospital, Katowice, Poland.
authors.forename: Dmytro
authors.initials: D
authors.lastname: Zaworonkow
authors.affiliation: Institute of Materials Science, University of Silesia, Katowice, Poland.
authors.forename: Zdzisław
authors.initials: Z
authors.lastname: Lekston
authors.affiliation: Department of Pathomorphology, Medical University of Silesia, Katowice, Poland.
authors.forename: Monika
authors.initials: M
authors.lastname: Ciupińska-Kajor
authors.affiliation: Medical University of Silesia, Katowice, Poland.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Seweryn
authors.affiliation: Department of Gastrointestinal Surgery, Medical University of Silesia, Katowice, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Lampe
mesh_terms: D000714:Anastomosis, Surgical; D057868:Anastomotic Leak / Q000517:prevention & control; D000818:Animals; D003125:Colostomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D004867:Equipment Design; D007081:Ileostomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D007422:Intestines / Q000473:pathology / Q000601:surgery*; D007582:Jejunostomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D008297:Male; D023421:Models, Animal; D061646:Operative Time; D011312:Pressure; D013525:Surgical Instruments; D034421:Sus scrofa; D013536:Suture Techniques / Q000009:adverse effects; D013997:Time Factors; D014945:Wound Healing