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The anastomotic technique plays a predominant role in
gastrointestinal surgery. A feared complication is leakage due to
the sutures. Such leakage cannot be detected early; consequently,
infection spreads locally and systemically. An anastomotic method
is generally evaluated according to its rate of leakage, related to
the localization, bur real scientific comparisons, i.e., controlled
studies, are almost totally lack ing. The criteria of evaluation
include the type of suture, the localization, the auxiliary
technical tools, practicability, the different forms of wound
healing, angiogenesis, and vascularization, among others. The
postoperative criteria are complications shortly after surgery,
such as bleeding, ruptures, and stenoses of the anastomosis. A
standard comparison is made difficult by the variety of
cytophysiological and biochemical factors that influence wound
healing. In the comparison of larger series one must always take
into account differences of auxiliary tools, strategies, and
inhomogeneity of patients. A change of one auxiliary tool or of one
strategy implies the modification of various target criteria. Often
enough, however, one does not sufficiently consider the surgeon's
most. important role."
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