Intraoperative bowel irrigation improves anastomotic collagen metabolism in the left-sided colonic obstruction but not covering colostomy

This study investigated the effects of intraoperative colonic irrigation an d proximal diverting end colostomy after segmental bowel resection in exper imental left-colonic obstruction on anastomotic healing. Simple obstruction of descending colon was performed in male Sprague-Dawley rats. After 24 h we performed segmental colonic resection and anastomosis in the control gro up (n=15); resection, anastomosis, and covering colostomy in the colostomy group (n=14); resection and anastomosis after antegrade colonic lavage thro ugh cecum by using isotonic saline solution in the irrigation group (n=13). In rats that were killed 7 days later anastomotic dehiscence and bursting pressure and tissue hydroxyproline concentration at the anastomosis were me asured. No significant differences were observed between groups in terms of anastomotic dehiscence, bursting site, or pressure. The hydroxyproline con centration was significantly higher in the irrigation group than the contro l group (P = 0.025) and the colostomy group (P = 0.029), but no difference was noted between the control group and the colostomy group. These findings suggest that intraoperative antegrade colonic irrigation in the acute left -sided colonic obstruction positively affects collagen metabolism at the an astomotic site; if the anastomosis is performed without bowel cleansing, co vering colostomy does not improve collagen metabolism.