TITLE:
Techniques for Avoiding Saccular Extended Obstruction at the Anastomotic Site of Functional End-to-End Anastomosis
AUTHORS:
Koichi Yoshida, Kenichi Ietsugu, Jyunpei Okamoto, Saki Hayashi, Yoshihide Asaumi, Naohiro Ota, Hiroyuki Sugawara, Satoshi Tabata, Masahiro Kaneki, Mitsuaki Sakatoku, Kaoru Kiyohara
KEYWORDS:
Functional End-to-End Anastomosis, Stapling Anastomosis, Anastomosis, Postoperative Complication, Intestinal Obstruction
JOURNAL NAME:
Surgical Science,
Vol.8 No.7,
July
18,
2017
ABSTRACT: Saccular extended obstruction is generated when the anastomotic site of functional end-to-end anastomosis is extended saccularly and blocked by intestinal contents. This is a specific complication of functional end-to-end anastomosis. Saccular extended obstruction of the anastomotic site of func-tional end-to-end anastomosis causes postoperative intestinal obstruction. Saccular extended obstruction places a heavy burden on patients because surgery is necessary for treatment of intestinal obstruction due to saccular extended obstruction. However, saccular extended obstruction is not a commonly recognized complication. The greatest factor contributing to the development of saccular extended obstruction is an acute angle between the portions of the intestinal tract oral and aboral to the anastomotic site. When this angle approaches obtuse angle, preferably close to a straight line, stagnation of the intestinal contents does not occur at the anastomotic site of functional end-to-end anastomosis and saccular extended obstruction is avoided. For making the angle of anastomotic intestinal tracts obtuse or straight, it may be effective that the entry hole of stapling suture instrument creating the anastomotic stoma is closed perpendicular to the intestinal axis.