1 : the union of parts or branches (as of streams, blood vessels, or leaf veins) so as to intercommunicate or interconnect.

Anastomoses occur normally in the body in the circulatory system, serving as backup routes for blood flow if one link is blocked or otherwise compromised. Anastomoses between arteries and between veins result in a multitude of arteries and veins, respectively, serving the same volume of tissue.

An anastomosis is a surgical connection between two structures. It usually means a connection that is created between tubular structures, such as blood vessels or loops of intestine.

A surgical anastomosis is an artificial connection made by a surgeon. It may be done when an artery, vein, or part of the intestine is blocked off. A surgeon will remove the portion that’s blocked in a procedure called resection. The two remaining parts will then be anastomosed, or joined together, and sewn or stapled.

There are three types: Arterioarterial anastomosis connects two arteries. Venovenous anastomosis connects two veins. Arteriovenous anastomosis connects an artery to a vein.

What are the three types of intestinal anastomosis?

• Side-to-side anastomosis: In this technique, the sides of each part of the bowel are either sutured or stapled rather than the two ends.
• End-to-end anastomosis: In this technique, the two open ends of the intestines are connected.

Important complications following intestinal anastomosis include the following:

• Anastomotic leak.
• Bleeding.
• Wound infection.
• Anastomotic stricture.
• Prolonged functional ileus, especially in children.

Collagen synthesis and composition are important determinants of anastomosis healing. In our study, the anastomotic healing rate of the control and experimental groups was 91.6% and 95.8%, respectively. The tensile strength of the anastomotic stoma decreased significantly within 3 or 4 days after anastomosis.

It has been stated that “the key to a successful anastomosis is the accurate union of two viable bowel ends with complete avoidance of tension”[3]. Thus, the most important factors in the creation of a bowel anastomosis are: (1) meticulous technique; (2) good blood supply; and (3) no tension.

A colectomy is a type of surgery used to treat colon diseases. These include cancer, inflammatory disease, or diverticulitis. The surgery is done by removing a portion of the colon. The colon is part of the large intestine.

A surgical procedure in which the side of the colon is attached to the anus after the rectum has been removed. A section of the colon about 2 inches long is formed into a mini-pouch in order to replace the function of the rectum and store stool until it can be eliminated.

Generally, in two-layer anastomoses, absorbable sutures of polyglycolic acid or polyglactin are used, with an outer seromuscular stitch of silk. In one-layer anastomoses, a nonabsorbable suture such as silk is preferred. The intestinal anastomosis is traditionally performed in two layers.

Primary anastomosis refers to a colonic resection with primary anastomosis and covering ileostomy, followed by a stoma reversal operation. Procedure: Primary anastomosis. Primary anastomosis refers to a colonic resection with primary anastomosis and covering proximal ileostomy, followed by a stoma reversal operation.

It has been widely accepted that intestinal wounds heal most reliably when an inverting suture line is constructed. The serosal surfaces of the bowel should be apposed by sutures, anchored in the submucosa, forming an inverting suture line. The wound should be kept free of hematoma, necrotic tissue, or infection.

Antibiotics and percutaneous drainage of fluid collections are the most common nonoperative interventions. Grade C anastomotic leakage requires relaparotomy. Surgical treatment is performed with the goal of controlling life-threatening sepsis.

Anastomotic leakage remains a severe complication after abdominal surgery with considerable morbidity and mortality [1–11]. The frequency ranges from 1.8 to 19.2% and depends partly on different risk factors [4, 12–20].

The most common clinical features of an anastomotic leak are abdominal pain and fever. They usually present between 5-7 days post-operatively. Other features* may include delirium or prolonged ileus. On examination, patients may be pyrexial, tachycardic, and / or with signs of peritonism.

The cause of the leakage may be multifactorial, including con tribution from faulty technique, ischemia of the intestine at the suture line, excessive tension across anastomosis and mesente ry, the presence of local sepsis, presence of obstruction distal to the anastomosis.

Core tip: 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 anastomotic leakage, including antibiotic prophylaxis, intraoperative air leak test.