Skip to main content

Advertisement

SpringerLink
Log in

Anastomotic healing after resection of left-colon stenosis: Effect on collagen metabolism and anastomotic strength

An experimental study in the rat

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

Anastomotic breaking strength and collagen metabolism in the colonic wall were studied after resection of a standardized left-colon stenosis in the rat. An increased complication rate was found in the stenosis group compared with the control group (27 percent us. 2 percent) and the complications arise soon after surgery. The collagen turnover in the anastomotic area, as well as the changes of breaking strength, were equal between the groups in the early healing course, implying that the stenosis group, as an entity, did not show impairment in the studied parameters predisposing for complications. Other factors such as mechanical strain by the increased fecal bulk and increased bacterial load may contribute to occurrence of the anastomotic complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Goligher JC, Smiddy FG. The treatment of acute obstruction or perforation with carcinoma of the colon and rectum. Br J Surg 1957;45:270–4.

    PubMed  Google Scholar 

  2. Welch JP, Donaldson GA. Management of severe obstruction of the large bowel due to malignant disease. Am J Surg 1974;127:492–9.

    PubMed  Google Scholar 

  3. Clark J, Hall AW, Moossa AR. Treatment of obstructing cancer of the colon and rectum. Surg Gynecol Obstet 1975;141:541–4.

    PubMed  Google Scholar 

  4. Irvin TT, Greany MG. The treatment of colonic cancer presenting with intestinal obstruction. Br J Surg 1977;64:741–4.

    PubMed  Google Scholar 

  5. Crooms JW, Kovalcik PJ. Obstructing left-sided colon carcinoma: appraisal of surgical options. Am Surg 1984;50:15–9.

    PubMed  Google Scholar 

  6. Savage PT. Immediate resection with an end-to-end anastomosis for carcinoma of the large bowel presenting with acute obstruction. Proc R Soc Med 1967;60:207.

    PubMed  Google Scholar 

  7. Fielding LP, Stewart-Brown S, Blesovsky L. Large bowel obstruction caused by cancer: a prospective study. Br Med J 1979;2:515–7.

    PubMed  Google Scholar 

  8. Koruth NM, Hunter DC, Krukowski ZH, Matheson NA. Immediate resection in emergency large bowel surgery: a 7 year audit. Br J Surg 1985;72:703–7.

    PubMed  Google Scholar 

  9. White CM, Macfie J. Immediate colectomy and primary anastomosis for acute obstruction due to carcinoma of the left colon and rectum. Dis Colon Rectum 1985;28:155–7.

    PubMed  Google Scholar 

  10. Törnqvist A, Blomquist P, Ahonen J, Jiborn H, Zederfeldt B. The effect of stenosis on collagen metabolism in the colonic wall: studies in the rat. Acta Chir Scand 1988;154:389–93.

    PubMed  Google Scholar 

  11. Stegeman H, Stalder K. Determination of hydroxyproline. Clin Chim Acta 1967;18:267–73.

    PubMed  Google Scholar 

  12. Pikkarainen J. The molecular structures of vertebrate skin collagens: a comparative study. Acta Physiol Scand 1968; Suppl 309:4–72.

    Google Scholar 

  13. Juva K, Prockop DJ. Modified procedure for the assay of H3- or C14-labeled hydroxyproline. Analyt Biochem 1966;15:77–83.

    PubMed  Google Scholar 

  14. Jiborn H, Ahonen J, Zederfeldt B. Healing of experimental colonic anastomosis: collagen metabolism in the colon after left colon resection. Am J Surg 1980;139:398–405.

    PubMed  Google Scholar 

  15. Atik M, Castleberry JW, Werner JC, Cohn I Jr. An experimental study of primary anastomosis of the obstructed colon. Surg Gynecol Obstet 1960;110:697–701.

    PubMed  Google Scholar 

  16. Leaper DJ. Angiography as an index of healing in experimental laparotomy wounds and colonic anastomoses. Ann R Coll Surg Engl 1983;65:20–3.

    PubMed  Google Scholar 

  17. Zlatarski G. Tierexperimentelle Untersuchungen ungeklärter Probleme beim Obstruktionsileus des Dickdrams. Bruns Beitr. Klin. Chir. 1973;220:626–36.

    PubMed  Google Scholar 

  18. Blomquist P, Jiborn H, Zederfeldt B. The effect of relative bowel rest on healing of colonic anastomosis: breaking strength and collagen in the colonic wall following colon resection and anastomosis in the rat. Acta Chir Scand 1984;150:671–5.

    PubMed  Google Scholar 

  19. Jonsson K, Jiborn H, Zederfeldt B. Mechanical and biochemical alterations in teh intestinal wall adjacent to an anastomosis. Am J Surgg 1986;151:387–90.

    Google Scholar 

  20. Hogstrom H, Haglund U. Postoperative decrease in suture holding capacity in laparotomy wounds and anastomoses. Acta Chir Scand 1985;151:533–5.

    PubMed  Google Scholar 

  21. Jiborn H, Ahonen J, Zederfeldt B. Healing of experimental colonie anastomoses: the effect of suture technique on collagen metabolism in the colonic wall. Am J Surg 1980;139:406–13.

    PubMed  Google Scholar 

  22. Blomquist B, Ahonen J, Jiborn H, Zederfeldt B. The effect of relative bowel rest on healing of colonic anastomosis: collagen synthesis and content in the colonic wall after left colon resection and anastomosis in the rat. Acta Chir Scand 1984;150:677–81.

    PubMed  Google Scholar 

  23. Uden P, Blomquist P, Jiborn H, Zederfeldt B. Influence of proximal colostomy on the healing of a left colon anastomosis. Br J Surg 1988;75:325–9.

    PubMed  Google Scholar 

  24. Uden P, Blomquist P, Jiborn H, Zederfeldt B. Healing of a left colon anastomosis following early colostomy closure. Int J Color Dis 1988;3:59–64.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery and Experimental Research, Malmö General Hospital, University of Lund, S-214 01, Malmö, Sweden

    Anders Törnqvist M.D., Peter Blomquist M.D., Hasse Jiborn M.D. & Bengt Zederfeldt M.D.

Authors
  1. Anders Törnqvist M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Peter Blomquist M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hasse Jiborn M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bengt Zederfeldt M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Supported by grants from the Swedish Medical Research Council, project number B86-17X-00640-22.

About this article

Cite this article

Törnqvist, A., Blomquist, P., Jiborn, H. et al. Anastomotic healing after resection of left-colon stenosis: Effect on collagen metabolism and anastomotic strength. Dis Colon Rectum 33, 217–221 (1990). https://doi.org/10.1007/BF02134183

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02134183

Key words

Search

Navigation