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PubMedDate not supplied

[Comparative study of cicatrization with suture technics in 1 or 2 layers in small intestine anastomosis in adverse conditions. Experimental work in dogs].

Some experimental procedures have shown in intestinal anastomosis advantages in the use of suture on only one plane as compared to the classical suture on two planes. However, these experiments, performed in healthy dogs, raised doubts about its safety when used under adverse clinical conditions. The objective of this work is, therefore, to compare in dogs submitted to immunosupressive drugs (azotioprine and corticoid) the two techniques of suture in the presence of peritonitis and intestinal ischemia. The comparative study of the healing in the sutures performed under such conditions shows the advantages in the use of suture on only one plane. In the dogs examined on the fourth and fifteenth day after surgery, the superiority of the suture on one plane compared to that on two planes is evident, both in the macroscopic and microscopic aspects. The suture in one plane shows a better coadaptation of the borders, without increasing the thickness of the wall at the level of the anastomosis, less exudative inflammatory reaction, quicker and greater fibroblastic proliferation, less inflammatory reaction to the suture material, and less vascular alteration at the healing level.

Animals↗
PubMed1985

[Significance of the suture technic and anastomosis sites for continence following deep rectum resection].

In a controlled clinical trial of 60 patients who underwent low anterior resection we found no influence of anal continence due to suture technique. Continence depends on the level and healing of anastomosis. Below a level of 6 cm from the anocutaneous line we more frequently found a reduction of functional reservoir in the 'neorectum', especially in cases with suture line leakage at anastomosis. Usually, the weakness of continence due to reduced functional reservoir was a temporary situation which lasted not longer than 6 months, if anastomosis healed without insufficiency.

Fecal Incontinence↗
PubMed1999

[Surgical treatment of mitral insufficiency using annuloplasty suture technic].

In 1991 a simple and cheap technique was introduced for mitral valve repair at our department. After repairing the mitral leaflets, where indicated a posterior leaflet annuloplasty was performed with a semicircular suture and the annulus fixed for the appropriate size by tying the stitch. Between July 1991 and December 1995 86 patients underwent the above procedure (average age 56.8 +/- 10.4 years). 45 patients had primary mitral valve disease (myxomatous degeneration, rheumatoid disease, endocarditis), the other 41 had functional mitral regurgitation secondary to severe aortic valve or coronary artery disease. Echocardiography showed severe mitral regurgitation in 77% of the patients. In 45 cases the mitral valve itself was also repaired (valvotomy, quadrangular resection, wedge resection, etc.) in 29 cases the aortic valve was replaced as well, while 24 patients required additional revascularisation of the myocardium. The 30 day mortality was 3.5%. One week after surgery echocardiography was performed at all patients and showed acceptable mitral valve area (2.28 +/- 0.39 cm2). In 28 cases mild mitral regurgitation was found, the other valves were competent. All but 3 patients were followed up (96.4%). There were 6 late deaths (3 cardiac, 2 non cardiac, 1 embolic, 7.2% late mortality). During the follow up period (31.7 +/- 11.2 months) 5 patients required mitral valve replacement for severe recurrent mitral regurgitation (6.0%). In two cases new chorda rupture caused the recurrence, in an other case the suture had torn out of the annulus due to inadequate surgical technique. In the last two cases the annulus had dilated with intact Prolene annuloplasty stitch present, 86.8% of the survivors were in NYHA class I. or II. Our results suggest that mitral valve repair in selected cases can be performed without using expensive annuloplasty rings. The suture used for annuloplasty should be strong, non absorbable and non stretchable. Since 1994, when we started using GoreTex suture instead of Prolene no more patients required reoperation for annuloplasty failure.

Adult↗