Latex rubber (Penrose drain) is detrimental to esophagogastric anastomotichealing in rats

Background. Surgeons commonly drain cervical esophagogastric anastomoses, b ut there is little objective evidence to support this practice. Studies in other areas of gastrointestinal surgery have shown that routine drainage is unnecessary, and even detrimental to anastomotic healing. We conducted an animal experiment to see if a drain had a negative effect on esophagogastri c anastomotic healing. Methods. Esophagogastric anastomoses were done in 40 rats. In the experimen tal group (20 rats) a portion of latex rubber Penrose drain was placed over the anastomosis, This was not done in the control group (20 rats). Rats we re sacrificed 7 days after surgery. The anastomoses were inspected for leak s, distracted in a tensiometer to measure breaking strength, and subjected to hydroxyproline analysis (an indicator of wound collagen). Results. There were 4 contained leaks in the experimental group (drain) and no leaks in the control rats (p=0.033), Anastomotic breaking strength was 3.80+/-0.81 N in the experimental rats and 3.46+/-0.64 N in the control rat s (p=0.18, not significant). Anastomotic tissue hydroxyproline concentratio n was 615.9+/-52 nmol/mg in the experimental rats and 609.4+/-195 nmol/mg i n the control rats (p=0.13, not significant). Conclusions. The presence of drain material predisposed to esophagogastric anastomotic leakage in this rat model.