BURSTING PRESSURE IN ANASTOMOTIC HEALING IN EXPERIMENTALLY-INDUCED COLITIS IN RATS

BACKGROUND: Experimental studies on healing of colonic anastomosis hav e been thoroughly investigated. However, clinical parameters of the he aling process of anastomosis in the inflamed colon has not yet been re ported. METHODS: In the present study, healing of anastomosis in trini trobenzene-sulfonic acid-induced colitis in rats was assessed by measu ring the bursting pressure and bursting wall tension. RESULTS: On post operative day 4, bursting pressure and bursting wall tension were sign ificantly lower (P < 0.001) in rats with colitis with or without anast omosis and normal colon with anastomosis, compared with normal colon w ithout anastomosis. On postoperative day 7, bursting pressure and burs ting wall tension of normal colon with anastomosis approached that of normal colon without anastomosis. However, bursting pressure and burst ing wall tension of rats with colitis with or without anastomosis rema ined significantly lower (P < 0.001) than the latter. Furthermore, unl ike rats without colitis in which perforation occurred mostly at the a nastomotic Line, the bursting site in colitic rats was predominantly a way from the anastomotic line. CONCLUSIONS: These results suggest that in surgery for inflammatory bowel disease, it is the adjoining inflam ed bowel wall that is vulnerable to be perforated in response to incre asing intraluminal pressure rather than the anastomosis that is braced by the sutures.