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Ann R Coll Surg Engl. 1988 November; 70(6): 345–347.
PMCID: PMC2498609

Intra-operative air testing: an audit on rectal anastomosis.


Thirty three patients having an anastomosis to the rectum were studied prospectively to determine the usefulness of intra-operative air testing. The pelvis was filled with saline and the anastomosis was distended with air. Any leaks demonstrated were oversewn. A Gastrografin enema was performed on all the patients on the eighth postoperative day. Overall, there were 4 (12%) clinical leaks and 10 (30%) radiological leaks. In six patients with air leaks demonstrated at operation, two had a radiological leak, one of which presented clinically as well. We believe that in the other four patients a potential leak was probably avoided as a result of intra-operative air testing. This technique is simple, safe and effective and probably helps reduce leakage after colorectal anastomosis.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Fielding LP, Stewart-Brown S, Blesovsky L, Kearney G. Anastomotic integrity after operations for large-bowel cancer: a multicentre study. Br Med J. 1980 Aug 9;281(6237):411–414. [PMC free article] [PubMed]
  • Goligher JC, Lee PW, Simpkins KC, Lintott DJ. A controlled comparison one- and two-layer techniques of suture for high and low colorectal anastomoses. Br J Surg. 1977 Sep;64(9):609–614. [PubMed]
  • Everett WG. A comparison of one layer and two layer techniques for colorectal anastomosis. Br J Surg. 1975 Feb;62(2):135–140. [PubMed]
  • Chassin JL, Rifkind KM, Sussman B, Kassel B, Fingaret A, Drager S, Chassin PS. The stapled gastrointestinal tract anastomosis: incidence of postoperative complications compared with the sutured anastomosis. Ann Surg. 1978 Nov;188(5):689–696. [PubMed]
  • Shorthouse AJ, Bartram CI, Eyers AA, Thomson JP. The water soluble contrast enema after rectal anastomosis. Br J Surg. 1982 Dec;69(12):714–717. [PubMed]
  • Matheson NA, Irving AD. Single layer anastomosis after rectosigmoid resection. Br J Surg. 1975 Mar;62(3):239–242. [PubMed]
  • McGinn FP, Gartell PC, Clifford PC, Brunton FJ. Staples or sutures for low colorectal anastomoses: a prospective randomized trial. Br J Surg. 1985 Aug;72(8):603–605. [PubMed]

Articles from Annals of The Royal College of Surgeons of England are provided here courtesy of The Royal College of Surgeons of England