High tie versus low tie in rectal surgery: comparison of anastomotic perfusion

N Komen, J Slieker, P de Kort, JHW (Johannes) de Wilt, E (Erwin) van der Harst, PP Coene, Martijn Gosselink, G Tetteroo, E (Eelco) de Graaf, T van Beek, R (Rene) den Toom, W van Bockel, Kees Verhoef, Johan Lange

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Both "high tie" (HT) and "low tie" (LT) are well-known strategies in rectal surgery. The aim of this study was to compare colonic perfusion after HT to colonic perfusion after LT. Patients undergoing rectal resection for malignancy were included. Colonic perfusion was measured with laser Doppler flowmetry, immediately after laparotomy on the antimesenterial side of the colon segment that was to become the afferent loop (measurement A). This measurement was repeated after rectal resection (measurement B). The blood flow ratios (B/A) were compared between the HT group and the LT group. Blood flow was measured in 33 patients, 16 undergoing HT and 17 undergoing LT. Colonic blood flow slightly decreased in the HT group whereas the flow increased in the LT group. The blood flow ratio was significantly higher in the LT group (1.48 vs. 0.91; p = 0.04), independent of the blood pressure. This study shows the blood flow ratio to be higher in the LT group. This suggests that anastomoses may benefit from better perfusion when LT is performed.
Original languageUndefined/Unknown
Pages (from-to)1075-1078
Number of pages4
JournalInternational Journal of Colorectal Disease
Issue number8
Publication statusPublished - 2011

Research programs

  • EMC MM-03-47-02-A
  • EMC MM-03-47-11
  • EMC OR-02-47-12

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