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J Surg Res. 2009 Jul;155(1):7-12. doi: 10.1016/j.jss.2008.08.019. Epub 2008 Sep 16.

Colorectal anastomotic leakage: a new experimental model.

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  • 1Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. nielskomen@hotmail.com

Abstract

BACKGROUND:

Anastomotic leakage is the major complication after colorectal surgery. To date, animal experiments concerning colorectal anastomosis focus on anastomotic healing instead of anastomotic leakage. This study aims to develop a new experimental model for colorectal anastomotic leakage.

METHODS:

A control group, receiving an anastomosis with 12 interrupted sutures, was compared to a group receiving an anastomosis with 6 interrupted sutures. When the leakage rate was observed to be too low, the number of sutures was decreased stepwise, to 5 or less. Each group contained 9 "C57Bl6-mice". After 7 d the Anastomotic Bursting Pressure (ABP) was determined.

RESULTS:

In the first experiment, one mouse (11.1%) in the case group and none in the control group developed leakage. Average ABP was 152.2 mmHg in the control group and 138,8 mmHg in the case group (P=0.111). In the second experiment, case group receiving an anastomosis with 5 sutures, 4 mice (44.4%) in the case group developed leakage. This experiment was repeated twice resulting in leakage rates of 33.3% and 44.4%. The average overall ABP in the case group was 142.7 mmHg vs. 179.9 mmHg (P=0.022) in the control group. The mice without leakage showed a stabilization of average weight loss around day 2 and 3 and a decrease afterwards. The mice with leakage showed a decrease only after day 5. The difference in wellness-scores between the groups with- and without leakage was 2 points, increasing during follow-up.

CONCLUSIONS:

The model of anastomotic leakage caused by creating an anastomosis with 5 interrupted sutures is feasible. Weight loss and wellness-scores are good predictors of leakage.

PMID:
19446852
DOI:
10.1016/j.jss.2008.08.019
[PubMed - indexed for MEDLINE]
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