Intra-abdominal anastomotic techniques

Volumes have been written describing numerous methods for joining together two segments of intestine. The specific technique favored by an individual surgeon depends more on training, personal experience, and perhaps blind faith than on results from randomized, prospective controlled studies. The fact is no one particular intestinal anastomotic technique has proven scientifically to be superior. It appears that, if general principles are followed, any technique of joining two segments of intestine together should in most instances result in uncomplicated healing. The objective of this review is not to describe in detail individual anastomotic techniques for which references are provided. Rather, the objectives are threefold: (1) to review the basic principles of intestinal anastomosis, (2) to explore the operative decisions a surgeon makes faced with numerous anastomotic options, and (3) to summarize the complications of intestinal anastomosis. Anastomotic choices discussed in the second objective include the decision to perform an anastomosis, impact of bowel preparation, mechanical or sutured techniques, and adjuncts to anastomoses.