Poly-ε-caprolactone scaffold for the reinforcement of stapled small intestinal anastomoses: a randomized experimental study
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Anastomotic leakage is a severe complication in gastrointestinal surgery. Different methods have been evaluated for anastomotic reinforcement to prevent anastomotic leakage. The aim of this study was to investigate the effect of a poly-ε-caprolactone (PCL) scaffold incorporated in the staple-line, on the anastomotic strength and histological wound healing, of small intestinal anastomoses in piglets.
This randomized experimental trial included 17 piglets. In each piglet, three end-to-end anastomoses were performed in the small intestine with a circular stapler, i.e. one control and two interventional anastomoses. On postoperative day 5, the anastomoses were resected and subjected to tension stretch test and histological examination.
No anastomotic leakage occurred. In the interventional anastomoses, the mean value for maximal tensile strength was 15.7 N, which was significantly higher than control anastomoses 12.7 N (p = 0.01). No statistically significant differences were found between the two groups in the histopathological parameters.
To conclude, this study has shown that the incorporation of a PCL scaffold in the staple-line was feasible and significantly increased the maximal tensile strength of small intestine anastomoses in piglets on postoperative day 5. The difference in histological parameters was not significantly distinct.
KeywordsPoly-ε-caprolactone Scaffold Intestinal anastomosis Reinforcement Colorectal surgery
The authors wish to thank veterinarian Louise Langhorn, head of Biomedical Laboratory Peter Bollen, and medical doctors Signe Steenstrup Jensen and Kristina Gosvig for their surgical assistance and support with animal care.
The data, methods used in the analysis and materials used to conduct the research will be made available to any researcher for the purposes of reproducing the results of replicating the procedure and can be accessed at https://www.dropbox.com/sh/yxtsd1vok0izn78/AADiu5bO8pimxYqTGK2Cn4P1a?dl = 0
K.D. Larsen and M. Westerholt conceived and designed the study, collected the data, analysed and interpreted the data, drafted the manuscript and obtained funding. G. Madsen collected the data, provided critical revisions and approved the final version of the manuscript. D.Q.S. Le conceived and designed the study, provided critical revisions and approved the final version of the manuscript. N. Qvist and M.B. Ellebæk conceived and designed the study, provided critical revisions that are important for the intellectual content and approved the final version of the manuscript.
Odense University Hospital Research Foundation financed the study (34-A1718).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All applicable international, national, and/or institutional guidelines for the care and use of animals were followed.
This article does not contain any studies with human participants performed by any of the authors.
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