Risk factors for leak in emergent small bowel anastomosis

Farghaly, Awatef E; Ammar, Mohamed Sabry; Algammal, Ahmed S; Arafa, Ahmed Sa

doi:10.4103/mmj.mmj_111_18

Cited by 4 publications

(1 citation statement)

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“…In addition, intra-abdominal adhesions are frequently asymptomatic and considered a common cause of chronic abdominal pain and bowel obstruction, making postoperative abdominal adhesion one of the most significant causes of concern ( 4 , 5 ). The tissue healing process is defined by tissue remodeling, granulation formation and proliferation, inflammation, and coagulation.…”

Section: Introductionmentioning

confidence: 99%

Innovative approach: utilizing silver nanoparticles sheet for improved rabbit cecal anastomosis healing

Almohamad,

Fahmy,

Farag

et al. 2024

Front. Vet. Sci.

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IntroductionAnastomotic leakage is a severe complication associated with gastrointestinal surgery. The process of intestinal wound healing is crucial for the successful outcome of digestive tract surgical repair procedures. This research aimed to determine the impact of silver nanoparticles sheet (Acticoat) on the anastomotic healing of the cecum in rabbits.MethodsA total of 48 New Zealand male rabbits in good health were used for cecum transection and anastomosis. The animals were randomized into the control group (C) and the silver nanoparticles group (AgNPs). In the C group, the transected cecum was end-to-end anastomosed with a single layer of simple continuous suture pattern using 3–0 polyglyconate. In contrast, a silver nanoparticle sheet (Acticoat) was covered around the sutured anastomotic line in the AgNPs group. Postoperatively, abdominal ultrasound imaging and the Bristol Rabbit Pain Score (BRPS) were measured on days 7, 15, and 30. Eight rabbits from each group were euthanized at each time point to assess macroscopic findings, bursting pressure tests, tensile strength tests, histopathological examinations, and immunohistochemical analyses.ResultsThe AgNPs group demonstrated a significant increase in the cecal lumen diameter wall (p ≤ 0.001), burst pressure measurement (p ≤ 0.02), and tensile strength (p ≤ 0.01). Conversely, the AgNPs group had significantly lower BRPS scores (p ≤ 0.01). In addition, histopathological examinations revealed that AgNPs significantly reduced inflammatory cell infiltration (neutrophils and macrophages) and enhanced collagen deposition. Immunohistochemical analyses revealed a significant increase (p ≤ 0.01) of α-SMA and a reduction of CD31 in the anastomotic tissue of the AgNPs group.DiscussionThe results of the present study indicate that the utilization of the AgNPs sheet (Acticoat®) effectively enhanced the strength of cecum anastomosis, resulting in a reduction in anastomosis leakages, pain scores, and abdominal adhesions. Additionally, the bursting pressure values in the rabbit model were significantly increased.

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Section: Introductionmentioning

confidence: 99%

Innovative approach: utilizing silver nanoparticles sheet for improved rabbit cecal anastomosis healing

Almohamad,

Fahmy,

Farag

et al. 2024

Front. Vet. Sci.

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Reinforcement of colon anastomosis healing with leukocyte platelet-rich fibrin in rabbit model

Albahrawy,

Abass,

Mosbah

et al. 2023

Life Sciences

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Characterizing the Suture Pullout Force for Human Small Bowel

Gong,

Yau,

Erickson

et al. 2023

Journal of Biomechanical Engineering

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Performing a small bowel anastomosis, or reconnecting small bowel segments, remains a core competency and critical step for the successful surgical management of numerous bowel and urinary conditions. As surgical education and technology moves toward improving patient outcomes through automation and increasing training opportunities, a detailed characterization of the interventional biomechanical properties of the human bowel is important. This is especially true due to the prevalence of anastomotic leakage as a frequent (3.02%) postoperative complication of small bowel anastomoses. This study aims to characterize the forces required for a suture to tear through human small bowel (suture pullout force, SPOF), while analyzing how these forces are affected by tissue orientation, suture material, suture size, and donor demographics. 803 tests were performed on 35 human small bowel specimens. A uni-axial test frame was used to tension sutures looped through 10 × 20 mm rectangular bowel samples to tissue failure. The mean SPOF of the small bowel was 4.62±1.40 N. We found no significant effect of tissue orientation (p = 0.083), suture material (p = 0.681), suture size (p = 0.131), age (p = 0.158), sex (p = .083), or body mass index (BMI) (p = 0.100) on SPOF. To our knowledge, this is the first study reporting human small bowel SPOF. Little research has been published about procedure-specific data on human small bowel. Filling this gap in research will inform the design of more accurate human bowel synthetic models and provide an accurate baseline for training and clinical applications.

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Risk factors for leak in emergent small bowel anastomosis

Cited by 4 publications

References 0 publications

Innovative approach: utilizing silver nanoparticles sheet for improved rabbit cecal anastomosis healing

Innovative approach: utilizing silver nanoparticles sheet for improved rabbit cecal anastomosis healing

Reinforcement of colon anastomosis healing with leukocyte platelet-rich fibrin in rabbit model

Characterizing the Suture Pullout Force for Human Small Bowel

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