Model of Wound Healing for Esophagogastric Anastomoses in Rats

Abstract

Background: Anastomotic leakage after esophageal surgery is a significant cause of morbidity and mortality. Postoperative leakage of esophagogastric anastomosis has been reported in 2–30% of surgical patient, resulting in an increased need for reoperation and a high risk of subsequent esophageal stricture formation and fistula. So far, experimental investigations on major factors influencing the healing of esophageal anastomoses, e.g. neovascularization and collagen deposition, have been hindered by the lack of a functional rodent model. Methods: We developed a novel technique of gastric tube formation followed by end-to-end esophagogastric anastomosis in a rat model. Standardized anastomoses were carried out in 18 Brown-Norway rats and normal esophagogastric healing was studied by measuring anastomotic breaking strength 5 days after surgery. Results: Five animals showed an insufficiency of the esophagogastric anastomosis as determined by anastomotic leakage testing. Normal anastomotic healing was found in 10 animals. The anastomotic breaking strength was 1.93 ± 0.45 N. Conclusion: The rat model for performing esophagogastric anastomoses after gastric tube formation may serve as a functional and useful model in future research studies on microvascular and molecular processes of anastomotic healing.

A Rat Model of Esophagogastric Anastomotic Stricture

“…Ischemia is considered a great risk factor for anastomosis leakage and stricture [12]. To our knowledge, most animal models designed for studying the esophagogastric anastomosis wound healing were focused on the postoperative leakage and used anastomotic bursting pressure to test the strength of anastomosis [13, 14], while only a few were designed to explore the anastomotic stricture. In conventional esophagectomy, the ischemia area is usually found at the tip of the gastric tube [15].…”

Esophageal Biomechanics Revisited: A Tale of Tenacity, Anastomoses, and Suture Bite Lengths in Swine

“…In contrast to intestinal anastomoses [16], esophageal anastomoses have seldom been experimentally assessed, although anastomotic leakages have deleterious consequences [1]. Esophagoesophageal [17] and gastroesophageal [18,19] anastomoses were evaluated for their tenacity in rats. One of these studies also tested burst pressures [18].…”

“…Esophagoesophageal [17] and gastroesophageal [18,19] anastomoses were evaluated for their tenacity in rats. One of these studies also tested burst pressures [18]. In addition, stapled porcine esophagointestinal anastomoses were investigated for their burst pressures [20].…”

Sex represents a relevant interaction in Sprague–Dawley rats: the example of oesophageal length*

“…In Levrat's model of oesophageal adenocarcinoma, rats are usually age-standardized despite a 10% variability of bodyweight for the same age. Oesophageal surgery in rats is generally considered difficult, (Cui & Urschel 1999; Tagkalos et al 2019) exemplified by a higher mortality (Man et al 1988;Drescher et al 2012;Gronnier et al 2013) than in intestinal anastomoses. (Marjanovic et al 2010) This difficulty might be reduced in larger and heavier animals with correspondingly larger oesophagi.…”