Colonic Ischaemia and Anastomotic Healing

Foster, M. E.; Brennan, S. S.; Morgan, Anthony; Leaper, David

doi:10.1159/000128458

Cited by 25 publications

(24 citation statements)

References 16 publications

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“…Blood flow is required for normal oxidative function of neutrophils, leukocyte activation, fibroblast production, angiogenesis and re-epithelization, which are essential for wound healing [4]. Our results correlate with many experimental studies which showed that ischemia impairs anastomotic wound healing [2,[4][5][6][7]. Bursting of all anastomoses in group 3 from the anastomotic line on the 7th day showed that anastomotic wound healing had not yet been completed.…”

Section: Resultssupporting

confidence: 74%

“…The risk of anastomotic dehiscence of colonic anastomosis has been reported to be 13% [2]. Ischemia is the major cause of colonic anastomosis impairment [3].…”

Section: Introductionmentioning

confidence: 99%

“…Isoxsuprine, oxygen free radicals, antibiotic prophylaxis and hyperbaric oxygen therapy have been used to improve the anastomosis of the ischemic colon segment. It has been shown that their use improves anastomotic wound healing on the ischemic colonic segment in experimental models [2,[4][5][6][7]. However, these agents have not been used in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Locally Applied Recombinant Human Granulocyte-Macrophage Colony-Stimulating Factor on Ischemic Bowel Anastomoses in Rat

et al. 2004

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Background: Ischemia is one of the most common causes of anastomosis disruption. In the present study we investigated the effect of locally injected recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) on ischemic bowel anastomosis in rats. Methods: 144 male Sprague-Dawley rats were randomized into four groups: in group 1, colon anastomoses were performed; in group 2, anastomoses were performed then 50 µg rhGM-CSF was injected subserosally into the perianastomotic area; in group 3, anastomoses were performed on ischemic colon segments, and in group 4, colon anastomoses were performed on ischemic segments and then 50 µg rhGM-CSF was injected subserosally into the perianastomotic area. On the 3rd and 7th post-operative days, the rats were sacrificed and anastomotic bursting pressures were measured. Hydroxyproline contents were studied on the tissues from the anastomotic line. Three anastomotic segments were saved from each group for histopathological studies before bursting pressure measurement. Results: The bursting pressure in group 3 was significantly weaker than in the other groups. There were no significant differences between the bursting pressures in groups 1 and 4. The levels of hydroxyproline content in group 4 were significantly greater than in group 3. Conclusions: These data suggest that the local injection of rhGM-CSF improves the healing of ischemic and even normal colon anastomoses.

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Section: Resultssupporting

confidence: 74%

“…The risk of anastomotic dehiscence of colonic anastomosis has been reported to be 13% [2]. Ischemia is the major cause of colonic anastomosis impairment [3].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of Locally Applied Recombinant Human Granulocyte-Macrophage Colony-Stimulating Factor on Ischemic Bowel Anastomoses in Rat

et al. 2004

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“…The most important prerequisite, however, for the healing of the bowel wound is an adequate blood supply. Foster et al [15] compared anastomoses in the normal and in the devascularized colon of the rat after 5 days by bursting pressure examination. He measured 290 and 180 mm Hg, respectively.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of the Healing Process of Two Single-Layer Suture Techniques for Experimental Small Bowel Anastomosis

Waninger¹,

Nöldge

et al. 1992

Dig Surg

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A comparison was made between the effect of the Gambee technique with inversion of the serosa and a submucosa technique on wound healing in small bowel anastomoses of 15 pigs. The submucosa technique avoids a broad serosal contact by burying the horizontally placed suture sling in the submucosal layer. Polydioxanon 4-0 and 6-0 served as suture material. Two anastomoses of each technique were constructed in one animal. Five animals were sacrificed after 4 days, 3 weeks, and 3 months, respectively. The anastomoses were evaluated by gross appearance, microangiography and histology. The submucosa technique resulted in a significant smaller scar with fewer necrotic areas (p < 0.01). It did not compromise the blood vessels in the knot area. This improved wound healing demonstrates that anastomotic healing does not necessitate broad serosal contact. Therefore, the submucosa technique may be considered for anastomoses of the compromised gut.

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“…5] or by induction of a traumatic hypovolemic shock [5][6][7], In both models the degree of localized bowel ischemia is dif ficult to standardize due to systemic effects of these proce dures.…”

Section: Discussionmentioning

confidence: 99%

Effects of Local Ischemia and Bacterial Flora on Healing of Experimental Colonic Anastomoses

D¹,

Izbicki²,

Sklarek³

et al. 1992

Dig Surg

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In the present study the effects of local bowel perfusion on anastomotic healing of experimental colonic anastomoses were evaluated in 54 female chinchilla rabbits. Local ischemia was induced by devascularization of the sigmoid colon. Animals were randomly allocated to 4 operative groups. In the animals of group 1 a colo-colonic anastomosis was performed in an area graded as ischemia grade A (intact perfusion). Animals of group 2 received a colo-colonic anastomosis in the sigmoid colon segment, graded as ischemia grade B (marginal perfusion). Group 3 received pretreatment with neomycin and was otherwise treated like group 2. Animals of group 4 a colo-colonic anastomosis was performed in the ischemia grade-C region (total ischemia). The rate of anastomotic leakage was monitored by periodic double contrast enemas. The experiment was terminated on the 8th postoperative day, and microangiography to assess revascularization was performed followed by assessment of perianastomotic adhesions. The rate of anastomotic failure as well as the occurrence of anastomotic failure over time highly depended on the severity of ischemia. Bowel sterilization by neomycin significantly reduced the rate of anastomotic leakage. The development of perianastomotic adhesions correlated with the severity of ischemia. Microangiography suggested that revascularization originated in the perianastomotic adhesions.

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Colonic Ischaemia and Anastomotic Healing

Cited by 25 publications

References 16 publications

Effects of Locally Applied Recombinant Human Granulocyte-Macrophage Colony-Stimulating Factor on Ischemic Bowel Anastomoses in Rat

Effects of Locally Applied Recombinant Human Granulocyte-Macrophage Colony-Stimulating Factor on Ischemic Bowel Anastomoses in Rat

A Comparison of the Healing Process of Two Single-Layer Suture Techniques for Experimental Small Bowel Anastomosis

Effects of Local Ischemia and Bacterial Flora on Healing of Experimental Colonic Anastomoses

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