• Hemicolectomy
• Laparoscopy
• Surgical anastomosis

• Antiperistaltic side-to-side anastomosis
• Ileocolic anastomosis
• Isoperistaltic side-to-side anastomosis
• Right hemicolectomy
• Scenario

• incisional wounds
• laser‐activated sealing
• photoacoustic imaging
• skin barrier function recovery
• tissue adhesive
• tissue repair
• ultrasound

• K01 EB031984 NIBIB NIH HHS
• R01 AR074627 NIAMS NIH HHS
• National Institute of Arthritis and Musculoskeletal and Skin Diseases
• National Institute of Biomedical Imaging and Bioengineering

• Anastomosis
• Colon
• Compression
• Handsewn
• Rectum
• Stapled

• Humans
• Surgical Stapling
• Suture Techniques
• Constriction, Pathologic
• Abscess
• Anastomosis, Surgical/methods
• Postoperative Complications
• Abdominal Abscess
• Intraabdominal Infections

• PD/BDE/142979/2018 Fundação para a Ciência e a Tecnologia
• UIDB/50026/2020 Fundação para a Ciência e a Tecnologia
• PD/BDE/142979/2018 José de Mello Saúde
• Universidade do Minho

• Anastomotic leakage
• Circular stapler
• Rectal cancer
• Rectal surgery
• Three-row stapler

• anastomotic technique
• ideal anastomosis
• intraoperative trauma
• postoperative complications

• the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation)

• Crohn's disease
• anastomosis
• disease recurrence

• anastomotic leakage
• colorectal surgeries
• prevention

• Anastomotic leak
• Colectomy
• Fecal incontinence
• Ileus
• Implantable neurostimulators
• Proctectomy

Colonic capsule endoscopy (CCE) derived from the video capsule endoscopy, initially proposed to explore the small bowel, has demonstrated high sensitivity and specificity for colonic polyp detection. The primary outcome of the study was to assess the safety, feasibility, and reliability of CCE after colorectal surgery. Secondary outcomes were to identify the detection rate of colonic lesions and recognition of the surgical anastomosis as compared to colonoscopy.

This is a prospective single-center study conducted over a 2-year period. Thirty-seven patients with a history of colorectal surgery were prospectively included in this study. Each patient received both CCE and colonoscopy, performed by different operators blinded to each other’s results.

Thirty-two patients (86.5%) completed the study and were included in the final analysis. All capsules were naturally expelled. In three patients (9.4%), the anal verge was not identified during the CCE recording and the examination of the colon was considered incomplete. Surgical anastomosis was accurately identified by CCE in 78.2% of the patients versus 93.8% for colonoscopy (P = 0.65). Thirty-eight lesions were detected in 14 patients. The sensitivity of CCE to detect colonic polyps was 95.2% (95% confidence interval (CI): 77.3-99.2%), the specificity 82.4% (95% CI: 59.0-93.8%). Positive predictive value (PPV) and negative predictive value (NPV) of CCE to detect colonic polyps were 87.0% and 93.3%, respectively. No complications related to the passage of the capsule through the intestinal anastomosis were detected.

CCE proved to be safe and feasible, reporting a similar detection rate of colonic lesion compared to colonoscopy.

• Colonic anastomosis
• Colonic capsule endoscopy
• Colonoscopy
• Colorectal cancer screening
• Follow-up after colorectal surgery
• Video

• Hand-sewn anastomosis
• Minimally invasive surgery
• Natural orifice specimen extraction (NOSE)
• Rectal cancer
• Sphincter preservation

The creation of a joint between two bowel ends in newborns and infants is one of the core surgical procedures in pediatric surgery. For a proper and perfect gastrointestinal (GI) anastomosis, the factors to be considered are intraoperative duration, restoration of normal GI function, effective hemostasis, reduction of tissue damage, and prevention of postoperative mortality and morbidity. The safety and efficacy of stapled GI tract anastomosis in adults have been extensively documented; however, available literature on the same is limited for infants.

Fifty-six patients were divided into two groups—stapled group and hand-sewn group. Patients operated on both emergency and elective basis were included in the study. Hand-sewn anastomosis was done by either end-to-end single-layer or double-layer anastomosis. Suture material used for the anastomosis was Vicryl 3-0 or Vicryl 4-0. Stapled anastomosis was done by 55 mm linear cutting GI stapler with side-to-side anastomosis.

The present study included a total of 56 patients; there were 28 neonates and 28 infants; 37 of them were males. The most common clinical presentations were vomiting, abdominal distention, refusal to feed, and lethargy. The intraoperative duration in stapled GI anastomosis was less when compared to hand-sewn anastomosis, so was the return of bowel activity and consequently early initiation of feeds and shorter hospital stay.

The present study favors stapled over hand-sewn GI anastomosis in infancy in view of decreased intraoperative duration, reduced blood loss, early return of peristalsis, early initiation of feeds, and shorter duration of hospital stay. However, a small number of patients and lack of matching are the shortcomings of this study.

Mitra AS, Chandak U, Kulkarni KK, et al. Stapled vs Conventional Hand-sewn Gastrointestinal Anastomosis during Infancy: A Prospective Comparative Study from Central India. Euroasian J Hepato-Gastroenterol 2020;10(1):11–15.

• Anastomosis
• Gastrointestinal
• Hand-sewn
• Infants
• Neonates
• Stapled

• Anastomosis
• Colorectal cancer
• Cáncer colorrectal
• Estenosis
• Estoma
• Stoma
• Stricture

• Side-to-side anastomosis techniques
• finite volume method
• fluid Dynamics
• functional end-to-end anastomosis techniques

Endoscopic stricturotomy (ESt) has been shown to be effective in treating inflammatory bowel disease (IBD)-associated anastomotic strictures. However, the outcome of ESt in benign, non-IBD conditions has not been described. The aim of this study was to evaluate the outcome of ESt in the management of IBD and non-IBD-associated strictures.

Data of all consecutive IBD and non-IBD patients with benign anastomotic strictures treated with ESt from 2009 to 2016 were extracted. The primary outcomes were surgery-free survival and procedure-related complications.

A total of 49 IBD and 15 non-IBD patients were included in this study. The IBD group included 25 patients with Crohn’s disease and 24 with ulcerative colitis and ileal pouches. Underlying diseases in the non-IBD group included colorectal cancer (n = 7), diverticulitis (n = 5), large bowel prolapse (n = 2), and constipation (n = 1). Immediate technical success was achieved in all patients in both groups. Bleeding complications occurred on five occasions (4.7% per procedure) in the IBD group, while no complication occurred in the non-IBD group (P = 0.20). Stricture improvement on follow-up endoscopy was found in 10 (20.4%) and 5 (33.3%) patients in the IBD and non-IBD groups, respectively (P = 0.32). Six (12.2%) patients in the IBD group and four (26.7%) patients in the non-IBD group eventually required stricture-related surgery (P = 0.23). IBD patients appeared to have a higher tendency for maintaining surgery-free after the procedure than non-IBD patients (P = 0.08).

Endoscopic stricturotomy was shown to have comparable outcomes, though non-IBD patients seem to have a higher need for subsequent surgery but a lower complication rate than IBD patients.

• anastomotic stricture
• endoscopic stricturotomy
• inflammatory bowel disease

Anastomosis is a crucial step in radical cancer surgery. Despite being a daily practice in gastrointestinal surgery, anastomotic leakage (AL) stands as a frequent postoperative complication. Because of increased morbidity, mortality, combined with longer hospital stay, the rate of re-intervention, and poor oncological outcomes, AL is considered the most feared and life-threatening complication after colorectal resections. Furthermore, poor functional outcomes with a higher rate of a permeant stoma in 56% of patients this could negatively affect the patient’s quality of life. This a narrative review which will cover intraoperative anastomotic integrity assessment and preventive measures in order to reduce AL. Although the most important prerequisites for the creation of anastomosis is well-perfused and tension-free anastomosis, surgeons have proposed several preventive measures, which were assumed to reduce the incidence of AL, including antibiotic prophylaxis, intraoperative air leak test, omental pedicle flap, defunctioning stoma, pelvic drain insertion, stapled anastomosis, and general surgical technique. However, lack of clear evidence of which preventive measures is superior over the other combined with the fact that the decision remains based on the surgeon’s choice. Despite the advances in surgical techniques, AL remains a serious health problem associated with increased morbidity, mortality with additional cost. Many preventative measures were employed with no clear evidence supporting the superiority of stapled anastomosis over hand-Sewn anastomosis, coating of the anastomosis, or pelvic drain. Defunctioning stoma, when justified it could decrease the leakage-related complications and the incidence of reoperation. MBP combined with oral antibiotics still recommended.

• Anastomotic leakage
• Colorectal
• Resection
• Anastomosis
• Cancer
• Anastomotic disruption

• Colorectal surgery
• Laparoscopic surgery
• Surgical site infection

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Analysis of Variance
• Colon/surgery
• Colonic Diseases/surgery
• Cross Infection/epidemiology
• Cross Infection/prevention & control
• Endoscopy, Gastrointestinal/statistics & numerical data
• Female
• Humans
• Laparoscopy/statistics & numerical data
• Male
• Middle Aged
• Retrospective Studies
• Risk
• Surgical Wound Infection/epidemiology
• Surgical Wound Infection/prevention & control
• Young Adult

• Anastomosis
• Intracorporeal
• Laparoscopy
• Right hemicolectomy

• Anastomosis, Surgical/adverse effects
• Clinical Audit
• Colectomy/adverse effects
• Endpoint Determination
• Humans
• Laparoscopy/adverse effects
• Reproducibility of Results
• Sample Size
• Randomized Controlled Trials as Topic

• IIBSP-AIE-2015-01 Fundació d'Investigació Sant Pau
• IIBSP-AIE-2015-1 Universitat Autònoma de Barcelona

• Carcinoma cell
• Cytological examination
• Double staple technique
• Suture line

• Adult
• Aged
• Aged, 80 and over
• Anastomosis, Surgical/adverse effects
• Anastomosis, Surgical/methods
• Carcinoma/pathology
• Carcinoma/surgery
• Colon/pathology
• Colon/surgery
• Colorectal Neoplasms/pathology
• Colorectal Neoplasms/surgery
• Constriction
• Female
• Humans
• Male
• Margins of Excision
• Middle Aged
• Neoplasm Recurrence, Local/etiology
• Rectum/pathology
• Rectum/surgery
• Surgical Stapling/adverse effects
• Suture Techniques/adverse effects

• automatic stitching
• best suturing pattern
• breaking strength
• design and fabrication
• hand suturing
• intestinal anastomosis
• tensile mechanical test

• colorectal cancer
• high ligation
• ima ligation
• mesenteric lymph nodes resection
• prognosis
• survival benefit

• Colorectal Neoplasms/mortality
• Colorectal Neoplasms/pathology
• Colorectal Neoplasms/surgery
• Colorectal Surgery/methods
• Humans
• Kaplan-Meier Estimate
• Ligation/methods
• Lymph Node Excision/methods
• Mesenteric Artery, Inferior/surgery
• Neoplasm Staging
• Postoperative Complications/epidemiology
• Prognosis
• Sentinel Lymph Node/pathology
• Sentinel Lymph Node/surgery

• anastomosis of intestine
• breaking strength
• edge-suture distance
• stich-stich distance
• techniques of anastomosis
• tensile test

This targeted chart review study reports the first ever detailed global account of clinical approaches adopted to detect and manage anastomotic leaks identified during surgery in routine clinical practice.

156 surgeons from eight countries retrospectively extracted data from surgical records of 458 patients who underwent colorectal surgery with an identified intraoperative leak at the circular anastomosis. Demographic details, procedures, and outcomes were analyzed descriptively, by country.

Most surgeries were performed laparoscopically (57.6%), followed by open surgeries (35.8%). The burden of intraoperative leaks on the healthcare system is driven in large part by the additional interventions such as using a sealant, recreating the anastomosis, and diverting the anastomosis to a colostomy bag, undertaken to manage the leak. The mean duration of hospitalization was 19.9 days. Postoperative anastomotic leaks occurred in 62 patients (13.5%), most frequently 4 to 7 days after surgery. Overall, country-specific differences were observed in patient characteristics, surgical procedures, method of diagnosis of intraoperative leak, interventions, and length of hospital stay.

The potential cost of time and material needed to repair intraoperative leaks during surgery is substantial and often hidden to the healthcare system, potentially leading to an underestimation of the impact of this complication.

Benign anastomotic strictures can occur in up to 22% of patients who undergo colonic or rectal resection. Traditionally, surgery was the preferred method of treatment, but, over time, endoscopic techniques, such as balloon dilation, have become the preferred modality. However, a high stricture recurrence rate of up to 18-20% and the increased risk of perforation due to uncontrolled stretching are its major drawbacks. Endoscopic electrocautery incision (EECI) allows for controlled mucosal incision in predetermined locations of stricture. In this meta-analysis, we have summarized case reports, case series, retrospective studies and prospective studies describing the different endoscopic EECI techniques used for benign lower gastrointestinal tract anastomotic strictures. Our analysis showed that EECI, either alone or in combination with other modalities (e.g. balloon dilation, steroid injection or argon plasma coagulation) is an effective treatment option for both treatment-naïve and refractory short non-inflammatory strictures. The overall success rate for EECI-based therapy for benign colorectal stricture was 98.4%, with a stricture recurrence rate of 6.0%. No major adverse event (bleeding, infection or perforation) was reported. Only minor adverse events (abdominal pain) were reported in 3.8% of the population.

• Keywords Benign stricture
• colorectal stricture
• endoscopic incision therapy

• Medical Knowledge
• Patient Care
• Practice-Based Learning and Improvement
• Professionalism
• Systems-Based Practice
• alimentary tract surgery
• anastomosis operation
• general surgery residency
• hand-sewn and stapled intestinal anastomoses created by residents
• surgical training

• Anastomosis, Surgical/education
• Clinical Competence
• Colonic Diseases/surgery
• Education, Medical, Graduate
• General Surgery/education
• Humans
• Internship and Residency
• Intestine, Small/surgery
• Laparoscopy/education
• Surgical Stapling
• Suture Techniques

• Anastomosis
• Inflammatory bowel disease
• Necrotising enterocolitis
• Paediatric surgery
• Technique

• Anastomosis por compresión (NiTi)
• Compression anastomosis (NiTi)
• Hemicolectomía izquierda
• Left hemicolectomy
• Low anterior resection of the rectum
• Resección anterior baja de recto

• Adult
• Aged
• Alloys
• Anastomosis, Surgical/instrumentation
• Blood Loss, Surgical
• Colectomy/instrumentation
• Colectomy/methods
• Female
• Humans
• Male
• Middle Aged
• Pressure
• Retrospective Studies
• Surgical Wound Dehiscence/prevention & control
• Wound Closure Techniques/instrumentation

• Anastomotic leak
• Colon cancer
• Colon resection
• Colorectal surgery
• Ileocolic anastomosis
• Postoperative complication
• Postoperative mortality
• Primary anastomosis
• Right colectomy
• Wound infection

• Inferior mesenteric artery
• anastomotic insufficiency
• neoplasm
• total mesorectal excision

• Compression anastomosis
• anastomotic leakage
• low anterior resection

• Cervical anastomosis
• Circular stapler
• Esophagectomy
• Hand-sewn
• Meta-analysis
• Systematic review

• Anastomosis
• Laparoscopic
• Rectal cancer