Changes of the extracellular matrix as a risk factor for anastomotic leakage after large bowel surgery

Stumpf, M.; Klinge, U.; Wilms, Arnulf; Zabrocki, Robert; Rösch, R.; Junge, K.; Krones, Carsten J.; Schumpelick, Volker

doi:10.1016/j.surg.2004.07.011

Cited by 118 publications

(97 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The LigaSure technique acts by sealing collagencontaining tissue layers [5], and because collagen, a protein, is abundantly present in the intestinal wall [16], the technique should theoretically be capable of creating intestinal sealing lines and thus intestinal anastomoses.…”

mentioning

confidence: 99%

Exploring new technologies to facilitate laparoscopic surgery: creating intestinal anastomoses without sutures or staples, using a radio-frequency-energy-driven bipolar fusion device

Smulders

Hingh

Stavast³

et al. 2007

Surg Endosc

View full text Add to dashboard Cite

Introduction: Intestinal anastomotic healing requires apposition of the collagencontaining submucosal layers of the opposing intestinal walls, which is traditionallyachieved by staples or sutures. Recently, a feedbackcontrolled bipolar sealingsystem (LigaSure) has been successfully introduced to seal and transect vessels.Since this technology depends on fusion of collagen fibres which are abundantlypresent in the intestinal wall, the possibility to create intestinal anastomoses usingthis technology was investigated in the present study. Materials and methods: For this purpose a newgeneration radiofrequency(RF) generator and a prototype of the Ligasure Anastomotic Device (LAD) have beendeveloped. The generator incorporates a closed loop control system which monitorstissue fusion, compares it with a mathematical model of ideal fusion based on thedensity and compliance of intestinal tissue and adjusts energy output accordingly. Intotal 8 anastomoses were created in a porcine model (4 pigs, 2 anastomoses each)and healing was assessed by macroscopic and histological examination. Results: All seals were macroscopic intact both immediate after creation and atsacrifice at the 7th postoperative day. Between operations, pigs appeared healthy andhad normal intestinal passage. Histological examination of the anastomoses revealedundisturbed healing with granulation tissue, newly synthesised collagen in thesubmucosa and re-epithelialization at the borders of the seals. Conclusion: These results confirm the feasibility to create experimental intestinalanastomoses using LigaSure technology. This may be an important step towards thedevelopment of new laparoscopic equipment combining dissecting and reconstructiveproperties within one single instrument.

show abstract

mentioning

confidence: 99%

Exploring new technologies to facilitate laparoscopic surgery: creating intestinal anastomoses without sutures or staples, using a radio-frequency-energy-driven bipolar fusion device

Smulders

Hingh

Stavast³

et al. 2007

Surg Endosc

View full text Add to dashboard Cite

show abstract

“…Increased fibrinolytic activity was also reported to result in adverse effects on wound healing. [3][4][5] In this study, we aimed to analyze whether hemoperitoneum caused unwanted effects on wound healing in colonic anastomosis by increasing fibrinolytic activity. In this experimental study, 30 female Wistar Albino rats were used.…”

Section: Resultsmentioning

confidence: 99%

“…[19] In animal experiments and a clinical research, a direct correlation between increased MMP expression and anastomotic leakage was demonstrated. [5,20] Plasmin and tissue activator of plasminogen, which act as structural elements of the fibrinolytic activity, contribute to the activation of collagenase (MMP-1), resulting in increased degradation of ECM proteins, such as collagen. [4] Thrombin-activatable fibrinolysis inhibitor (TAFI) is a procarboxypeptidase that is synthesized in the liver.…”

Section: Discussionmentioning

confidence: 99%

Effects of hemoperitoneum on wound healing and fibrinolytic activity in colonic anastomosis

Köksal¹,

Uzun²,

Özkan³

et al. 2012

Ulus Travma Acil Cerrahi Derg

View full text Add to dashboard Cite

“…[20,21] MMP-1, -2, and -9 levels in peroperative intestinal biopsies were elevated in patients who developed anastomotic wound failure after colorectal resection. [22] While, MMP inhibitors have been shown to improve healing of intestinal and cutaneous wounds [23,24,25] MMP-3 levels appear to be related to the prognosis of osteoarthritis as well. MMP inhibitor therapy has already been tried.…”

Section: Mmps and Adamtsmentioning

confidence: 99%

Analysis of ADAMTS, MMPs, Versican and Related Proteoglycans in Origin and Progression of BRONJ

Sidhu¹

2015

J Cont Med A Dent

View full text Add to dashboard Cite

show abstract

Changes of the extracellular matrix as a risk factor for anastomotic leakage after large bowel surgery

Cited by 118 publications

References 26 publications

Exploring new technologies to facilitate laparoscopic surgery: creating intestinal anastomoses without sutures or staples, using a radio-frequency-energy-driven bipolar fusion device

Exploring new technologies to facilitate laparoscopic surgery: creating intestinal anastomoses without sutures or staples, using a radio-frequency-energy-driven bipolar fusion device

Effects of hemoperitoneum on wound healing and fibrinolytic activity in colonic anastomosis

Analysis of ADAMTS, MMPs, Versican and Related Proteoglycans in Origin and Progression of BRONJ

Contact Info

Product

Resources

About