Srpski arhiv za celokupno lekarstvo 2011 Volume 139, Issue 5-6, Pages: 333-338
https://doi.org/10.2298/SARH1106333I
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Intraoperative air testing of colorectal anastomoses
Ivanov Dejan (Hospital for Abdominal, Endocrine and Transplantation Surgery, Clinical Centre of Vojvodina, Novi Sad)
Cvijanović Radovan (Hospital for Abdominal, Endocrine and Transplantation Surgery, Clinical Centre of Vojvodina, Novi Sad)
Gvozdenović Ljiljana (Hospital for Anaesthesia and Intensive Therapy, Clinical Centre of Vojvodina, Novi Sad)
Introduction. Intraoperative anastomotic air testing of stapled colorectal
anastomosis is performed by filling the pelvis with saline solution and
insufflating the rectum with air through a sigmoidoscope. The presence of air
bubbles indicates anastomotic leaks which are resolved during surgery.
Objective. The aim of this prospective, randomized study was to perform a
comparative analysis regarding the number of anastomotic dehiscences in
patients checked by air leak testing and in the control group without air
testing. Methods. After stapled colorectal anastomosis was performed,
patients were randomized into two groups of 30 patients. The first group
patients underwent intraoperative anastomotic air testing, whereas in the
control group this procedure was not performed. The two groups were matched
for age, sex, diagnosis and surgical procedure. Results. Intraoperative air
tests were positive in seven cases and anastomotic defects were repaired.
After surgery, there were three clinical leaks in this group of patients. In
the control group, there were six leaks (Unilateral Fischer’s exact test,
p=0.24). The incidence of colorectal anastomotic dehiscences in the study
group was lower than in the control group by 50%. However, this finding was
not statistically significant in our sample. Conclusion. In our opinion,
intraoperative air testing of colorectal anastomosis is a good method for
prevention of anastomotic dehiscence.
Keywords: rectal neoplasms, sigmoid neoplasms, surgical stapling, anastomosis, surgical, postoperative complications, surgical wound dehiscence
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