Comparative analysis of Side-to-End and End-to-End intestinal anastomosis techniques: insights from a rat model study.

Abstract

Background: Optimal selection of anastomosis technique is crucial in colectomy surgeries to ensure success and minimize postoperative complications. Various methods, both manual and stapler-assisted, are employed for intestinal anastomosis. This study aims to compare two surgical methods of intestinal anastomosis through macroscopic and microscopic examination.

Methods: Twenty-five albino Wistar rats were randomly divided into two groups: the first group (n = 10) underwent Side-to-End anastomosis, while the second group (n = 15) underwent End-to-End anastomosis. After a 5-day observation period under uniform laboratory conditions, both groups underwent a second surgery. Anastomoses were assessed for adhesion and leakage, followed by histopathological examination of excised samples using the oxygenal method. Data were analyzed using the Mann-Whitney statistical method with a significance level of p < 0.05.

Results: Following the initial surgery, the second group exhibited a higher mortality rate compared to the first group. Based on our data, the mortality of the rats was unrelated to the type of anastomosis or the surgical procedure. The higher mortality rate in one group was due to other factors. Additionally, the second group demonstrated significantly greater adhesion formation. Histopathological examination revealed no significant difference between the groups, although neovascularization and collagen accumulation appeared more pronounced in the Side-to-End group.

Conclusion: Histopathologically, Side-to-End anastomosis showed superior repair conditions compared to End-to-End anastomosis. However, due to the limited sample size, statistical significance was not achieved. Conversely, Side-to-End anastomosis was associated with increased adhesion formation. These findings suggest the need for further comprehensive studies with larger sample sizes conducted in well-equipped centers to ascertain the preferred distal colon anastomosis technique and to achieve statistically significant results that can be more reliably generalized.