anastomosen

Anastomosis, plural anastomoses (Anastomosen in some languages), is a connection between two hollow or tubular structures formed either surgically or physiologically to restore continuity. The most common contexts are vascular, enteric (gastrointestinal), biliary and urinary systems, but the term applies to any joined luminal duct or vessel.

Surgical anastomoses are created to reestablish flow after resection, bypass a blockage, or connect donor and recipient tissues in transplantation. They are configured in several ways depending on the relative positions of the structures: end-to-end (connecting the ends), end-to-side (end of one segment to the side of another), and side-to-side (two sides joined). Techniques include hand-sewn sutures and stapling devices, and may be performed with or without adjuncts such as stents or drains.

Enteric anastomoses are common after intestinal resections, such as ileocolic or jejunojejunostomy, and require meticulous technique to ensure luminal patency and watertight closure. Biliary anastomoses connect bile ducts or hepatic ducts, frequently in liver surgery or transplantation. Vascular anastomoses link arteries and/or veins, enabling bypasses and graft attachments; ureteral and pancreatic duct anastomoses are other examples.

Healing depends on tissue quality, perfusion, tension, and infection risk. Complications include anastomotic leakage, stricture, thrombosis, and infection, which can compromise function and require intervention. Postoperative imaging or endoscopy may assess patency and integrity.

The concept of anastomosis is widely used in surgery and radiology, reflecting the goal of restoring continuity between formerly connected luminal structures.