Impaired healing of extraperitoneal intestinal anastomoses
Background: The extra‐anatomical position of a cervical oesophagogastrostomy might be a reason for impaired anastomotic healing. Methods: This hypothesis was tested in a rat model. Jejunal resection with an end‐to‐end jejunojejunostomy was placed intra‐abdominally in group 1 (n = 24) and subcutaneou...
Gespeichert in:
Veröffentlicht in: | British journal of surgery 1999-05, Vol.86 (5), p.680-684 |
---|---|
Hauptverfasser: | , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
Zusammenfassung: | Background:
The extra‐anatomical position of a cervical oesophagogastrostomy might be a reason for impaired anastomotic healing.
Methods:
This hypothesis was tested in a rat model. Jejunal resection with an end‐to‐end jejunojejunostomy was placed intra‐abdominally in group 1 (n = 24) and subcutaneously in group 2 (n = 30). Jejunum without anastomosis was placed subcutaneously in group 3 (n = 12). After 3, 7 or 14 days the rats were killed; the bursting pressure of the anastomosis or jejunum was measured and the hydroxyproline level was determined.
Results:
Two of 24 rats in group 1 and eight of 30 in group 2 died following anastomotic leakage (P not significant) and were excluded from other measurements. Bursting pressure was decreased after 3 days in group 1 (mean(s.e.) 62(10) mmHg) and group 2 (57(10) mmHg) compared with that in group 3 (204(17) mmHg) (P < 0·001). After 7 days, it was in the normal range in group 1 (200(14) mmHg), but lower in group 2 (104(15) mmHg) compared with that in group 3 (230(8) mmHg) (P < 0·001). Differences in hydroxyproline levels were not statistically significant between the groups after 3, 7 and 14 days.
Conclusion:
Healing of jejunojejunostomies is impaired in an extraperitoneal position compared with an intra‐abdominal position. © 1999 British Journal of Surgery Society Ltd |
---|---|
ISSN: | 0007-1323 1365-2168 |
DOI: | 10.1046/j.1365-2168.1999.01118.x |