Left-sided colon and colorectal anastomoses: Doppler ultrasound as an aid to assess bowel vascularization. A prospective evaluation of 200 consecutive elective cases.

Two hundred non-randomized left-sided colon and colorectal anastomoses were performed on 199 con- secutive patients admitted over a 4-year period (107 men and 92 woman with a median age of 66 years). There were 117 high anastomoses (above the peritoneal reflection), 86 (74%) of which were hand sewn, and 83 low anastomoses, 78 (94%) stapled with an EEA instrument. Adequate blood supply was assessed with a Doppler ultrasound in all but 5 cases. In ten patients bowel edges to be anastomosed were recut because of a negative Doppler ultrasound read- ing. One hundred and eighty-nine anastomoses were ra- diologically controlled. In-hospital post-operative mortal- ity was 2.5% and morbidity 20%. There were two (1%) clinical anastomotic leaks and three (1.5%) radiological leaks. Use of Doppler ultrasound is simple and safe to as- sess vascularization of the intestinal edges. It may have contributed to the low anastomotic complication rate ob- served in this series.