J.Jpn. Surg. Soc.. 80(11): 1145-1149, 1979

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Report on the annual meeting

HEALING PROCESS AND PROBLEMS AT GASTROINTESTINAL ANASTOMOTIC SITE
―COMPARISON BY ANASTOMOSIS PROCEDURES―

The site of gastrointestinal anastomosis should be healed without serious complications like insufficient suture and stricture but recovery in terms of smooth movement is also desired. From healing standpoint, selection of suturing procedure, technique, and materials are questioned, and type of anastomosis such as end-to-end and side-to-side anastomoses is questioned from viewpoint of movement.
Histomorphological studies were made on healing processes following Albert-Lembert, layer-to-layer and Gambee anastomoses. The results revealed that layer-to-layer anastomosis, in which wound edges were easily approximated, brought about the best healing process. As for technique that requires accuracy and careful attention, two-layer suture was found safer than single layer suture, and Albert-Lembert anastomosis was found useful in preventing insufficient susure by union of serosa.
Regarding suture materials, polyglycolic acid (PGA), silk and catgut were compared. PGA was found the best with least tissue reaction and without unfavorable effect on suture wound.
Comparison of end-to-end and side-to-side anastomoses was made electrophysiologically by electromyogram and disclosed that end-to-end anastomosis was better from movement aspect because of rapid recovery. Side-to-side anastomosis was found undesirable and should be avoided if possible because of some disadvantages including formation of blind pouch in blind end on mouth side.
In summary, it is considered most desirable to select layer-to-layer anastomosis which is technically easy and brings about favorable healing process, to use P.G.A. suture and, if possible, to employ end-to-end suture.

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