Clinical and Experimental Studies of Gastro-Intestinal Anastomotic Techniques

McGregor, John Robert (1988) Clinical and Experimental Studies of Gastro-Intestinal Anastomotic Techniques. MD thesis, University of Glasgow.

Abstract

Introduction Recent years have witnessed the introduction and increasing application of surgical stapling instruments in gastro-intestinal surgery. This thesis is directed towards an investigation of the potential implications of this new technology with respect to both immediate and long term post-operative outcome. Clinical and experimental studies were carried out and these are considered separately. Clinical Studies: Despite the increasing use of automated stapling devices for the construction of gastro-intestinal anastomoses, few attempts have been made to objectively compare these instruments with conventional manual suturing methods. In an attempt to clarify the role of stapling in modern surgical practice, a multicentre controlled clinical trial was designed with the aim of comparing the immediate clinical results associated with sutured and stapled anastomotic techniques. Experimental Studies: For many surgeons, the introduction of the circular stapling instrument has enabled them to construct anastomoses deeper within the pelvis than was previously possible with traditional manual suturing methods. Combined with a general trend away from abdomino-perineal excision of the rectum for rectal cancer in favour of sphincter preserving procedures, this has led to a much greater proportion of patients with this disease undergoing low anterior resection. There has, however, been some concern regarding a possible association between stapled colorectal anastomoses and an increased incidence of local recurrence of colorectal carcinoma. The experimental work carried out for this thesis was designed to explore the possible mechanisms of local recurrence and to investigate the potential influence of the choice of anastomotic suture material. (Abstract shortened by ProQuest.).

• Item Type: Thesis (MD)
• Qualification Level: Doctoral
• Keywords: Medicine, Surgery
• Date of Award: 1988
• Depositing User: Enlighten Team
• Unique ID: glathesis:1988-77790
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 14 Jan 2020 11:53
• Last Modified: 14 Jan 2020 11:53
• URI: https://theses.gla.ac.uk/id/eprint/77790