PROTECTION OF INTESTINAL ANASTOMOSES IN SEPTIC ENVIRONMENT WITH PERITONEAL GRAFT AND POLYGLYCOLIC ACID MESH - AN EXPERIMENTAL-STUDY

We carried out an experimental study in dogs to evaluate the outcome o f large bowel anastomosis with 6 stitches (Group C, n:6) in a septic e nvironment with protection by a polyglycolic acid (PGA) mesh (Group M, n:12) or peritoneal graft (Group P, n:12). Thirty dogs were used to c ompare the techniques. Two dogs in each group were re-operated after 3 , 5, 7, 14, 28 and 90 days. They were evaluated for adhesion formation , lumen diameter (anastomotic index), clinical features, histologic ap pearance and quality of healing at the anastomotic sites. All dogs in group P and group M survived, whereas 2 dogs in the control group died of anastomotic leakage and 3 dogs were re-operated for anastomotic le akage and peritonitis. In group M, one dog was reoperated because of t he anastomotic leakage and two dogs were reoperated because of the ana stomotic stenosis. Also, 4 anastomoses showed evidence of moderate ste nosis. In group P, three anastomoses were graded as minimal stenosis. Histopathologic evaluation showed more complete epithelization, less i nflammation, and less adhesion in group P than group M. We could not f ind any study in the literature that described and compared both techn iques. We report here the results of such a study.