Intestinal Anastomosis

The creation of a join between two bowel ends is an operative procedure that is of central importance in the practice of a general surgeon. Leakage from an intestinal anastomosis can be disastrous, resulting in prolonged hospital stays and increased risk of mortality. To minimize the risk of potential complications, it is important to create a tension-free join with good apposition of the bowel edges in the presence of an excellent blood supply. This review discusses the factors that influence intestinal anastomotic healing, the various technical operations for creating anastomoses, and operative techniques currently used in constructing anastomoses. Tables review the principles of successful intestinal anastomosis, consequences of postoperative dehiscence, factors linked with dehiscence, anastomotic techniques ranked by best blood flow to the healing site, comparison of hand and stapled techniques, leak rates from the Rectal Cancer Trial on Defunctioning Stoma and the Contant and colleagues mechanical bowel obstruction trial, leak and wound infection rates from mechanical bowel obstruction meta-analyses, diseases and systemic factors associated with poor anastomotic healing, lifes