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Quitzan et al: Influence of staple line number and configuration on the leakage of small intestinal functional end-to-end stapled anastomosis: An ex vivo study
Veterinary Surgery 5, 2022

🔍 Key Findings

  • All FEESA configurations leaked at lower pressures than intact segments, confirming reduced integrity vs. native tissue.
  • FEESA with 3-row transverse staples (3V/3T or 2V/3T) had significantly higher leak pressures than 2-row configurations.
  • 3V/3T configuration had the highest ILP (69.88 ± 21.23 mmHg) among all groups, significantly greater than 2V/2T and 3V/2T (P < .001).
  • Leakage consistently occurred at the transverse staple line (not vertical), regardless of configuration.
  • No significant difference in maximum intraluminal pressure (MIP) between FEESA groups.
  • All FEESA constructs withstood intraluminal pressures >25 mmHg, exceeding normal physiological jejunal pressure in dogs.
  • No leaks occurred from the vertical staple line, highlighting it as a more robust closure site.
  • Third staple row in transverse line may be a viable alternative to suture oversew, pending further clinical evaluation.

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← Articles

Quitzan et al: Influence of staple line number and configuration on the leakage of small intestinal functional end-to-end stapled anastomosis: An ex vivo study
Veterinary Surgery 5, 2022

🔍 Key Findings

  • All FEESA configurations leaked at lower pressures than intact segments, confirming reduced integrity vs. native tissue.
  • FEESA with 3-row transverse staples (3V/3T or 2V/3T) had significantly higher leak pressures than 2-row configurations.
  • 3V/3T configuration had the highest ILP (69.88 ± 21.23 mmHg) among all groups, significantly greater than 2V/2T and 3V/2T (P < .001).
  • Leakage consistently occurred at the transverse staple line (not vertical), regardless of configuration.
  • No significant difference in maximum intraluminal pressure (MIP) between FEESA groups.
  • All FEESA constructs withstood intraluminal pressures >25 mmHg, exceeding normal physiological jejunal pressure in dogs.
  • No leaks occurred from the vertical staple line, highlighting it as a more robust closure site.
  • Third staple row in transverse line may be a viable alternative to suture oversew, pending further clinical evaluation.

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Multiple Choice Questions on this study

In Quitzan 2022 et al., on staple line configuration, which FEESA combination demonstrated the highest initial leak pressure (ILP)?

A. 2-row vertical, 2-row transverse (2V/2T)
B. 2-row vertical, 3-row transverse (2V/3T)
C. 3-row vertical, 2-row transverse (3V/2T)
D. 3-row vertical, 3-row transverse (3V/3T)
E. Control (intact segment)

Answer: 3-row vertical, 3-row transverse (3V/3T)

Explanation: The 3V/3T configuration yielded the highest ILP (69.88 ± 21.23 mmHg) among FEESA groups.
In Quitzan 2022 et al., on staple line configuration, what was concluded about the vertical staple line?

A. It was the most common site of leakage
B. It showed significantly lower MIP
C. It showed significantly higher ILP
D. No leakage occurred from this location
E. It was reinforced with oversew

Answer: No leakage occurred from this location

Explanation: No FEESA constructs leaked from the vertical staple line in the study.
In Quitzan 2022 et al., on staple line configuration, where did initial leakage most frequently occur in the FEESA constructs?

A. Vertical staple line
B. Transverse staple line
C. Anastomotic crotch
D. Suture line junction
E. Entire staple line

Answer: Transverse staple line

Explanation: Initial leakage was most commonly observed at the transverse staple line regardless of staple row number.
In Quitzan 2022 et al., on staple line configuration, which FEESA variation did *not* significantly increase ILP compared to 2V/2T?

A. 2V/3T
B. 3V/3T
C. 3V/2T
D. All had increased ILP
E. None were significantly different

Answer: 3V/2T

Explanation: 3V/2T did not show a statistically significant increase in ILP vs. 2V/2T, unlike 2V/3T and 3V/3T.
In Quitzan 2022 et al., on staple line configuration, which FEESA group had significantly higher ILP than both 2V/2T and 3V/2T groups?

A. 2V/3T
B. 3V/3T
C. 2V/2T
D. 3V/2T
E. Control (intact segment)

Answer: 3V/3T

Explanation: 3V/3T was significantly stronger (P < .001) in ILP than 2V/2T and 3V/2T groups.

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