Hm. Schardey et al., BACTERIA - A MAJOR PATHOGENIC FACTOR FOR ANASTOMOTIC INSUFFICIENCY, Antimicrobial agents and chemotherapy, 38(11), 1994, pp. 2564-2567
The aim of this study was to determine the influence of bacteria on th
e development of anastomotic insufficiency following gastrectomy in th
e rat. Fifty-seven male Wistar rats were randomly assigned to three gr
oups and subjected to gastrectomy. Group I (n = 20) was orally inocula
ted with 10(9) Pseudomonas aeroginosa organisms on postoperative day 1
. Group II (n = 20) served as the control group. Group III (n = 17) wa
s decontaminated with 320 mg of tobramycin, 400 mg of polymyxin B, and
500 mg of vancomycin per liter of fluid administered from preoperativ
e day 7 to postoperative day 10. Swabs from the oropharynx and rectum
were cultured and analyzed daily for gram-positive and gram-negative b
acteria. Surviving animals were sacrificed on postoperative day 10. Al
l animals were autopsied immediately following death. Anastomotic insu
fficiency was defined as a histologically proven transmural defect at
the suture line. Along with an effective reduction of pathogenic bacte
ria colonizing the oropharynx, the rate of anastomotic insufficiency c
ould be reduced significantly, to 6% in decontaminated animals compare
d with 80% in controls (P < 0.001 by Fisher's exact test). Inoculation
of group I animals with P. aeruginosa led to an increase of anastomot
ic insufficiency up to 95% and a significant increase in mortality (P
< 0.05). We conclude that bacteria play a major role in the pathogenes
is of anastomotic insufficiency following gastrectomy in the rat.