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Where to cut when performing a resection-anastomosis

Chapter 11: Table of Contents

Where to cut when performing a resection-anastomosis

Transect the intestine in a ‘viable’ area. Cut the bowel ends at an angle (longer on the mesenteric border than on the antimesenteric border) to ensure good blood supply to the intestinal anastomosis. If the tissues at the cut end don’t look healthy, remove more. All of the grossly abnormal intestine should ideally be removed. This becomes difficult in cases with extensive intestinal trauma caused by linear foreign bodies since resection of 70-80% of the small intestinal length or more results in short-bowel syndrome. Because short bowel syndrome leads to severe diarrhea, bacterial overgrowth and weight loss, the surgeon must, in some cases, cut the intestine in a less than ideal location to allow for enough intestinal length to remain; this obviously increases the risk of dehiscence.

Intestinal resection and anastomosis

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