Anastomotic disruption after large bowel resection

Table 1 Prospective randomized trials comparing the effect of mechanical bowel preparation versus no preparation on anastomotic leaks in elective colorectal surgery (n, %)

Investigators	Number ofpatients	Bowel preparationgroup (leak rate)	No bowel preparation group (leak rate)	P
Miettinen et al[25]	267	4%	2%	0.28
Zmora et al[26]	380	3.7%	2.1%	0.50
Santos et al [27]	149	10%	5%	0.52
Burke et al [28]	186	7.8%	11%	0.90

Table 2 Clinical studies utilizing sutures for fashioning colorectal anastomosis

Investigators	Number ofpatients	Types of suture	Continuous vs interrupted	Leak rate(%)
Max et al[45]	1 000	Non-absorbable	Continuous	1
Mann et al[46]	320	Absorbable	Interrupted	3.4
Flyger et al[47]	105	Absorbable	Continuous	1
Deen et al[48]	26	Absorbable	Interrupted	3.9

Table 3 Clinical studies utilizing staples for fashioning colorectal anastomosis

Investigators	Study design	Number of patients	Leak rate (%)
Detry et al[49]	Prospective	1 000	3.5
Griffen et al[50]	Prospective	75	2.7
Cohen et al[51]	Prospective	26	3.8
Laitinen et al[52]	Prospective	39	5.3
Baran et al[53]	Retrospective	104	2.8
Karanjia et al[54]	Prospective	276	11
Hansen et al[55]	Prospective	615	1.5
Memon et al[56]	Prospective	218	3

Table 4 Comparison of stapled versus sutured colorectal anastomoses

Investigators	Number ofpatients	Staple techniqueleak rate (%)	Suture techniqueleak rate (%)	P
Docherty et al[57]	732	4.7	4.3	0.93
Fingerhut et al[58]	113	13	18.7	0.05
Everett et al[59]	100	0	2	NS
Demetriades et al[60]	207	6.3	7.8	0.69

NS = not significant.