A prolonged interval between deep intestinal ischemia and anastomotic construction does not impair wound strength in the rat.

Contains fulltext : 51827.pdf (publisher's version ) (Closed access)INTRODUCTION: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: Extending the interval between transient deep intestinal ischemia and construction of an anastomosis does not impair wound strength

Early anastomotic repair in the rat intestine is affected by transient preoperative mesenteric ischemia.

Contains fulltext : 80885.pdf (publisher's version ) (Closed access)INTRODUCTION: During bowel surgery, perioperative blood loss and hypotension can lead to transient intestinal ischemia. Recent preclinical studies reveal that the strength of intestinal anastomoses can be compromised after reperfusion. So far, this phenomenon has not been investigated in the very first days of healing when wound strength is lowest. MATERIAL AND METHOD: Ischemia was induced in rats by clamping both the superior mesenteric artery and ileal branches for 30 min. Immediately after declamping, anastomoses were constructed in both terminal ileum and descending colon. The same was done in control groups after sham-ischemia. Anastomotic bursting pressure and breaking strength were measured immediately after operation (day 0) and after 1, 2, or 3 days. Anastomotic hydroxyproline content, gelatinase activity, and histology were analyzed. RESULTS AND DISCUSSION: In ileal anastomoses, at day 1, both the breaking strength and bursting pressure were significantly (p < 0.05) lower in the ischemic group, while at day 2, this was the case for the bursting pressure only. In the colon, the bursting pressure in the ischemic group was lower at day 1. Anastomotic hydroxyproline content remained unchanged. Increased presence of the various gelatinase activities was found in ileum only at day 0 and in colon at days 1 and 2. Histological mucosal damage was found in ischemia-reperfusion groups. CONCLUSION: Transient mesenteric ischemia can negatively affect anastomotic strength during the very first days of healing, even if the tissue used for anastomotic construction looks vital