Anastomosis

Anastomosis (Greek: anastómōsis — opening) is a natural or surgically created connection between hollow anatomical structures, such as blood vessels, lymphatic ducts, or sections of hollow organs (e.g., the intestine).

Natural anastomoses play an important physiological role by providing collateral (bypass) blood circulation. Surgical anastomoses are created to restore the continuity of an organ after resection of part of it or to form a bypass (shunt).

Classification and principles of formation

Surgical anastomoses are classified according to the type of tissue connection: “end-to-end”, “side-to-side” and “end-to-side”. The success of their formation and healing depends on adherence to strict surgical principles:

• Adequate blood supply to the areas being joined.
• No tension on the seam line.
• Ensuring the tightness of the connection.
• Careful matching of homogeneous layers of organ walls.

Clinical Significance

Anastomosis is a key step in abdominal, vascular, and oncological surgery. The main and most dangerous complication is the failure of the anastomosis seams, which leads to the development of bleeding (in vascular anastomoses) or peritonitis (intestinal anastomosis), sepsis, and often requires repeat surgery.

In the long-term postoperative period, anastomotic stricture may develop; it is a scar tissue narrowing that impairs organ patency.

Differential Diagnosis

Anastomosis should be distinguished from a fistula. An anastomosis is a deliberately formed therapeutic connection, whereas a fistula is a pathological passage that forms spontaneously as a result of disease or complications.