- Anastomotic healing requires good blood flow, but the colonic vascular supply can be compromised by resection.
- Collagen matrix in the submucosa is essential for structure and healing.
- Intestinal microbiota probably influence leaks, but more research is required for us to understand this process.
- The order in which resection and anastomosis is performed and its anatomical arrangement matter less than the need to ensure a good blood supply and the formation of a tension free anastomosis.
- The decision between creating a hand sewn or stapled anastomosis should be individualised to each patient.
- There are specific scenarios where stapled anastomosis is likely to be inappropriate.
The video below summarises a key learning point from this module, with a discussion about choice of handsewn versus stapled anastomoses: