Anastomosis

Anastomosis is a connection between two hollow or tubular structures that enables flow or passage of fluids, air, or contents between them. The term derives from Greek ana- “up” and stoma “mouth.” In medicine, anastomosis most often refers to a surgical connection created to restore continuity after resection, to bypass obstruction, or to connect a graft to a vessel.

Anastomoses occur in both natural physiology and surgical reconstruction. Common contexts include vascular (arterial or venous), intestinal, biliary, ureteral, lymphatic, and airway connections. Configurations are described by how the lumens are joined: end-to-end, end-to-side, or side-to-side.

Techniques vary by tissue and purpose. Sutured anastomosis uses fine sutures to join the luminal edges; stapled anastomosis employs stapling devices; microvascular anastomosis, performed with magnification, connects small vessels or nerves and may involve grafts. Adjuncts such as tissue adhesives or stents may be used in some situations.

Complications can include anastomotic leak, bleeding, infection, fistula formation, stenosis, and thrombosis, all of which can impair function or require revision. Successful anastomosis depends on tension-free alignment, adequate blood supply, precise apposition of edges, and control of infection.

In practice, anastomosis is a fundamental concept in reconstructive and transplant surgery, enabling restoration of continuity and function after disease, injury, or operative resections. Postoperative assessment often involves imaging or endoscopy to evaluate patency and healing.