COMPARISON OF CONSEQUENT SMALL-BOWEL ANASTOMOSES AFTER TRANSIENT ISCHEMIA - AN EXPERIMENTAL-STUDY IN RATS

Background/Purpose: The role of ischemia/reperfusion (I/R) damage on i ntestinal anastomotic healing remains to be precisely determined. The objective of this study was to investigate healing of small bowel anas tomoses performed at different times after transient ischemia. Methods : Thirty male Wislar-Albino rats were investigated in five groups (fou r study and one control). Under general anesthesia, the superior mesen teric artery (SMA) was occluded for 40 minutes in the study rats. Biop sy specimens, to document I/R histopathology, were obtained before sma ll intestinal anastomoses at 20 minutes (group 1), 90 minutes (group 2 ), 6 hours (group 3), and 24 hours (group 4) after reperfusion. In a c ontrol group, biopsy and intestinal anastomoses were performed after S MA disection without occlusion. The rats were relaparotomized on the f ifth day to determine in situ bursting pressures and to obtain specime ns for hydroxyproline content and histopathologic evaluation. Results: Hydroxyproline content and bursting pressures were compared statistic ally with Mann-Whitney U test. Although there was no statistical diffe rence between the control group and group 1, there were significant di fferences (P < .05) between groups 2, 3, and 4, with both parameters d ecreasing as the duration after reperfusion increased. Conclusion: Ana stomosis are less likely to leak when performed sooner rather than lat er after an ischemia/reperfusion event. Copyright (C) 1998 by W.B. Sau nders Company.