OBJECTIVE

To evaluate universal intestinal suture in rehabilitation of patients with single-row anastomoses after elective upper gastrointestinal tract surgery.

MATERIAL AND METHODS

A single-center study included 142 patients over 8-year period. There were 72 (50.7%) pancreaticoduodenectomies and 70 (49.3%) gastric resections and gastrectomies. The rehabilitation program included single-layer anastomoses using universal intestinal suture, intestinal drainage for decompression and enteral nutrition, therapeutic and diagnostic endoscopy to stimulate motor evacuation function, patency of anastomoses and assessment of anastomositis.

RESULTS

Intestinal drainage for decompression and enteral nutrition was used for 6 (4; 7) days after surgery. Intraluminal endoscopy was performed after 9 (7; 11) days. In patients with anastomositis grade 0 (26.5%) and 1 (62.4%), we observed minimal inflammation along intestinal suture line (mean hospital-stay 16 (13; 20) days). In patients with anastomositis grade 2 (8.5%) and 3 (2.6%), we observed surface erosions and ulcers in the anastomosis zone (mean postoperative hospital-stay 20 (16; 27) days). Postoperative complications unrelated to anastomoses were diagnosed in 17.6% of cases; 12% of patients underwent redo surgery. Mortality rate was 2.8%.

CONCLUSION

Universal intestinal suture in rehabilitation of patients with single-layer anastomoses contributed to uncomplicated healing of anastomoses in 88.9% of patients with anastomositis grade 0—1 and reduced the incidence of anastomositis grade 2—3 to 11.1%, as well as hospital-stay after elective upper gastrointestinal tract surgery.