Sestre Milosrdnice University hospital and Institute of Clinical Medical Research
Abstract
The effect of relative bowel rest on the strength of surgical anastomoses in the left colon in the early phase of healing, and correlation between mechanical strength of anastomosis and collagen content in the colonic wall were investigated. The breaking strength of surgical stitches in the left colon after end-to-end anastomosis and collagen content in the colonic wall around the anastomosis were measured and evaluated in rats fed low residue or standard diet. The anastomosis strength decreased by approximately 30% of the immediate postoperative value in the first two days in both groups. After day 2, there was an increase in the anastomosis strength, reaching day 0 strength after 7 days. The strength increase was mainly due to collagen deposition in the anastomosis. From day 0 till day 2, the increase in collagen content was greater in the standard laboratory diet group than in the low residue diet group. Results on anastomotic adhesions and condition of anastomosis sutures in animals on the standard laboratory diet group and low residue diet group are also presented. Low residue diet did not impair the suture holding capacity or anastomosis strength. Instead, there was evidence for a more uncomplicated healing when the bowel content was diminished.Istraživan je utjecaj crijevnog sadržaja na snagu anastomoze lijevog kolona u ranoj fazi cijeljenja, te odnos između mehaničke snage anastomoze i sadržaja kolagena u crijevnoj stjenci. Mjerena je i procijenjena snaga pucanja kirurških šavova na lijevom kolonu nakon termino-terminalne anastomoze, te sadržaj kolagena u crijevnoj stjenci oko anastomoza kod štakora kojima je davana hrana s minimalnim ostatkom i štakora hranjenih standardnom hranom. Snaga anastomoze se smanjila za oko 30% u odnosu na neposrednu poslijeoperacijsku vrijednost u prva dva dana kod obje skupine životinja. Nakon drugog dana snaga anastomoze postupno je rasla, da bi sedmoga dana dosegla poslijeoperacijske vrijednosti. Ovaj porast snage uglavnom je bio uvjetovan odlaganjem kolagena u crijevnu stjenku oko anastomoze. Od nultog do drugog dana porast sadržaja kolagena bio je veći u skupini životinja na standardnoj prehrani. Prikazane su i pojave priraslica oko anastomoza, te stanje kirurških šavova kod životinja koje su dobivale hranu s minimalnim ostatkom i onih na standardnoj prehrani. Prehrana s minimalnim ostatkom ne utječe na snagu anastomoze i stanje kirurških šavova anastomoze. Ipak, očito je da smanjenje crijevnog sadržaja doprinosi boljem cijeljenju anastomoza
