Relativno mirovanje crijeva i zaraštanje anastomoza kolona (original) (raw)
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Relative Bowel Rest and Healing of Colonic Anastomoses
2004
SUMMARY 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 sutu...
Bali Medical Journal
Backgrounds: Mechanical bowel preparation (MBP) was almost considered dogmatic in colorectal surgery. There are several methods known to perform MBP. Anastomotic leakage is considered higher in patients who had MBP, and it is thought due to alteration colonic morphologic, electrolyte and fluid imbalance. Methods: This is an experimental study divided into two groups. This study aims to determine the difference in collagen density, amount of fibroblast and histopathologic features in the anastomotic site between Wistar rats that had MBP and without MBP to the colonic anastomosis. The first group consists of 6 Wistar rats who had colonic anastomosis without MBP, and the second group consists of 6 Wistar rats who had colonic anastomosis with BMP. On the 10 th day after surgery, histopathology examination is performed with regards to collagen density, the number of fibroblasts, infiltration of inflammatory cells and the degree of bowel wall damage at the anastomotic site. Independent t-test is used to analyze the data if it is normally distributed and Mann-Whitney test is used if the data is not normally distributed. Results: The amount of fibroblast was significant difference between two groups (p=0.02), which is amount of fibroblast in the second group (3.83 ± 0.408) is higher than the first group (2.33 ± 0.816). Meanwhile, there is no significant difference regarding collagen density, infiltration of inflammatory cells and the degree of bowel wall damage (p=0.59, p=0.082 dan p=1.00). Conclusion: The conclusion of this research is by performing MBP prior to colonic anastomosis will exert the effect of more abundant fibroblast.
Different Surgical Methods in Colon Anastomosis: Experimental Study
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)
- BACKGROUND: Although many methods have been defined for colonic anastomosis, anastomotic leak still remains important for sepsis control and successful healing. AIM: The purpose of this study was to compare the effects of conventional suture, polyglactin 910 mesh, and omental flap coverage on healing and anastomotic leak in experimental colonic anastomosis in rats. METHOD: This study was conducted on 18 Wistar rats and the animals were divided into three groups as follows: Group 1: primary suture group; Group 2: primary suture plus polyglactin 910 mesh group; and Group 3: primary suture plus omental flap coverage group. Groups were compared in terms of anastomotic bursting pressure, inflammation, fibroblastic activity, neovascularization, and collagen amount. RESULTS: There was a statistically significant difference in anastomotic bursting pressure between Groups 1 and 2 and between Groups 1 and 3 (p=0.004, p<0.05). There was a significant difference in fibroblastic activity be...
International Journal of Surgery, 2011
Introduction: Anastomotic dehiscence remains an important challenge for colorectal surgeons worldwide. Extensive research focused on performing a safe anastomosis is conducted with rats being the most used model when examining colorectal anastomoses. In daily clinical practice resorbable sutures are used when hand-sewn anastomoses are performed. However, in the experimental studies examining colorectal anastomoses, non-resorbable sutures have predominantly been used. The aim of this study was to compare a rapidly resorbable suture with a non-resorbable suture in experimental colorectal anastomoses. Methods: This was an experimental, prospective, case-control study using forty male Wistar rats. A colonic anastomosis was performed in a standardized fashion with either rapidly resorbable or nonresorbable suture. On the seventh postoperative day, the animals were sacrificed and the breaking strength of the anastomoses was measured. Results: No suffering or poor wellbeing of the animals was registered. No animals died or were prematurely sacrificed. At tissue harvesting, no anastomotic leaks or signs of peritonitis were registered. The breaking strengths of the anastomoses were comparable in the two groups (median 2.175 (range 1.479e2.880) Newton vs. 2.267 (1.290e4.042) Newton (P ¼ 0.256) for resorbable and non-resorbable sutures, respectively). We found no significant correlations between pre-to postoperative weight-loss and anastomotic strength. Conclusion: Non-resorbable suture was comparable with rapidly resorbable suture with regards to breaking strength of an experimental colonic anastomosis. Thus, absorbable suture can be used in experimental studies which then more easily can be compared to clinical practice.
The comparison of the suture materials on intestinal anastomotic healing: an experimental study
Turkish Journal of Trauma and Emergency Surgery
BACKGROUND: This experimental comparative study was to evaluate the local effects of three different suture materials on intestinal anastomosis healing. METHODS: Ethical approval was obtained from the University of Ethical Committee (E-60758568-020-176720). A prospective, experimental comparative analysis was conducted on 24 rats. They were divided into three equal groups; Group 1 underwent colonic anastomosis with Vicryl suture material, Group 2 underwent colonic anastomosis with polypropylene suture; and Group 3 underwent colonic anastomosis with polydioxanone (PDS) suture. The second operation underwent the 7th post-operative day. Adhesion score, anastomotic leakage, anastomotic bursting pressure, hydroxyproline levels, and histopathologic examination were evaluated. RESULTS: All animals survived, and no leakage, intestinal obstruction, or wound infection was observed during the experiment. The adhesion score was evaluated according to the Diamond classification and same in all groups. Median anastomotic bursting pressure
A Research Model of Measuring the Tensile Strength of Colonic Anastomosis in Wistar Rats
2014
The present experimental study investigates the mechanical behavior of intestinal anastomoses in Wistar rats. More specifically the response of the anastomoses to a properly applied uniaxial direct tensile load is studied and the respective tensile strength is determined. The surgical procedure of large bowel anastomoses is described in detail. In addition the authors provide a thorough description of the experimental apparatus, designed especially for measuring the tensile strength of the specimens under study, with special consideration in gripping of the intestine, the load application and the data acquisition and storage systems. This experimental model provides an excellent method for measuring the anastomotic strength and therefore a flexible tool for the comparative evaluation of various anastomotic techniques.
Collagenolytic activity in experimental intestinal anastomoses
International Journal of Colorectal Disease, 1992
Collagen degradation is thought to be an integral part of the healing sequence of intestinal anastomoses, but almost nothing is known about the enzyme activities involved. We have studied collagenolytic activities, extracted from I day-old intestinal anastomoses in the rat. Using either soluble type I collagen or fibrillar type I or type III collagen as a substrate, activities measured in extracts from anastomotic segments were compared to those in extracts from uninjured intestine, removed at operation: in all cases, the collagenolytic activity in anastomotic extracts was significantly higher. This increase was significantly more pronounced in large bowel than in small bowel. The activities were strongly inhibited by serum and metallo-chelating compounds. Analysis, by means of SDS-polyacrylamide gel electrophoresis, of the reaction products of the degradation of fibrillar type I collagen by the extracts revealed the presence of a multitude of fragments, amongst them TeA fragments characteristic for the activity of mammalian collagenase. Thus, the degradative capacity towards various collagen substrates is enhanced in the anastomotic area during the first postoperative period and a true mammalian collagenase is one of the enzymes present.