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Anastomotic Sealing by Extracellular Matrices (ECM) Improves Healing of Colonic Anastomoses in the Critical Early Phase

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

Extracellular matrices have proven potential for in vivo tissue regeneration at gastrointestinal luminal organs. In this study, small intestinal submucosa (SIS) was tested as a sealant for colonic anastomoses in a rodent model.

Methods

In the rodent model, standard colonic anastomoses in the control group (CG; n = 30) and anastomoses sealed by omentum (n = 30) were compared to SIS-sealed anastomoses in the study group (SG; n = 30). After 4-, 30-, and 90-day macroscopic and microscopic healing, bursting pressure and anastomotic stricture rate were evaluated.

Results

The rate of anastomotic dehiscence was 1/10 after 4 days and 0/10 after 30 and 90 days in all groups. In the SG, the bursting pressure was significantly increased after 4 days compared to CG (148 ± 9 vs. 108 ± 8 mmHg; p > 0.05). Histologically, after 4 days of neovascularization, fibroblast ingrowth and collagen deposition were significantly increased in SG compared to CG. After 30 days, nonsignificant differences were noted in all three parameters. Adhesion rate and anastomotic stricture rate were not significantly affected by SIS sealing after 4, 30, and 90 days.

Conclusion

Especially in the critical phase of anastomotic healing up to day 4, anastomotic healing was improved by SIS sealing. SIS sealing did not cause long-term complications.

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Authors and Affiliations

  1. Department for General and Visceral Surgery, University of Freiburg, Hugstettter Str. 55, 79106, Freiburg, Germany

    Jens Hoeppner, Bettina Wassmuth, Goran Marjanovic, Ulrich Theodor Hopt & Tobias Keck

  2. Department of Pathology, University of Freiburg, Freiburg, Germany

    Sylvia Timme

Authors
  1. Jens Hoeppner
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  2. Bettina Wassmuth
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  3. Goran Marjanovic
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  4. Sylvia Timme
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  5. Ulrich Theodor Hopt
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  6. Tobias Keck
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Correspondence to Jens Hoeppner.

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Hoeppner, J., Wassmuth, B., Marjanovic, G. et al. Anastomotic Sealing by Extracellular Matrices (ECM) Improves Healing of Colonic Anastomoses in the Critical Early Phase. J Gastrointest Surg 14, 977–986 (2010). https://doi.org/10.1007/s11605-010-1191-1

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  • DOI: https://doi.org/10.1007/s11605-010-1191-1

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