D. Garciaolmo et al., THE EFFECTS OF THE PHARMACOLOGICAL MANIPULATION OF POSTOPERATIVE INTESTINAL MOTILITY ON COLONIC ANASTOMOSES - AN EXPERIMENTAL-STUDY IN A RAT MODEL, International journal of colorectal disease, 12(2), 1997, pp. 73-77
Introduction: The aim of the study was to determine the effects of pha
rmacological manipulation of postoperative intestinal motility on the
resistance of colonic anastomoses. Materials and methods: Seventy-one
Spraque-Dawley rats were divided into three groups: Group 1 (n = 20; c
olonic anastomosis + 1 cc of saline solution subcutaneously, daily); G
roup 2 (n = 29; colonic anastomosis + 1.2 mg/100 g body weight metoclo
pramide in 1 cc subcutaneously, daily); and Group 3 (n = 22; colonic a
nastomosis + 2 mg/100 g body weight hyoscine N-butylbromide in 1 cc su
bcutaneously, daily). Surviving rats (20 in each group) were sacrifice
d 4 days after surgery and adhesions were evaluated. Each segment cont
aining an anastomosis was removed and the bursting pressure was determ
ined. Results: The cause of death during the early postoperative perio
d was dehiscence in 8 cases (7 in Group 2 and 1 in Group 3). General a
dhesion scores in Group 2 were higher than in Group 3 (P = 0.003). The
score for adhesions to the anastomosis in Group 1 was higher than in
Group 2, but no statistically significant difference was found. Bursti
ng pressure was significantly lower in Group 2 than in other groups (P
= 0.001). In all cases leakage of dye was observed at the anastomosis
. Conclusion: The use of metoclopramide (a gastrointestinal prokinetic
agent) during the early postoperative period was associated with an i
ncrease in dehiscence in colonic anastomosis and, when animals survive
d, there was a significant decrease in anastomotic resistance. Hyoscin
e (an inhibitor of gastrointestinal motility) did not improve the heal
ing of anastomoses.