A prolonged interval between deep intestinal ischemia and anastomotic construction does not impair wound strength in the rat
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Transient intestinal ischemia can reduce anastomotic strength, which poses an increased risk of complications. The objective of this study is to establish if a prolonged interval between profound ischemia and construction of an anastomosis affects anastomotic strength.
Male Wistar rats were used: in experimental groups, profound mesenteric ischemia was induced by clamping both superior mesenteric artery and more distal arteries in the ileal mesentery. Resection and anastomosis in ileum and colon were performed immediately (IR0) or 24 h after releasing the clamps (IR24). In controls (C0 and C24), arteries were not clamped. After 5 days, anastomotic bursting pressure (BP), breaking strength (BS), and hydroxyproline were measured, and histological analysis was performed.
Mortality and anastomotic dehiscence rates were significantly higher in IR0 compared to C0. In ileum, the BS was 34% lower (p < 0.05) in IR0 compared to C0, while there were no significant differences in BS or BP between the IR24 and C24 groups. In colon anastomoses, although no differences in BS and BP were found, bursting site was at the anastomosis in 82% in group IR0 vs 30% in group C0, reflecting reduced anastomotic strength in the former. Again, after 24 h, there were no differences between IR and C group. Hydroxyproline and histology were not different between groups.
Extending the interval between transient deep intestinal ischemia and construction of an anastomosis does not impair wound strength.
KeywordsIschemia Reperfusion Anastomosis Intestine
The authors thank B.M. de Man and R.M.L.M. Lomme for their expert technical assistance, Dr. A. Verhofstad for his valuable comments on the histology, and Dr. J. van der Laak for his assistance with the digital image analysis software.
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