Does a proximal colostomy affect colorectal anastomotic healing?

1992 ◽  
Vol 35 (2) ◽  
pp. 182-188 ◽  
Author(s):  
Anthony Senagore ◽  
Jeffrey W. Milsom ◽  
Richard K. Walshaw ◽  
Robert Dunstan ◽  
Irshad H. Chaudry
Keyword(s):  
Anastomotic Healing ◽  
Proximal Colostomy

scholarly journals Ileocolonic Healing After Extended Small Bowel Resection in Mice: NOD2 Deficiency Impairs Anastomotic Healing and Postoperative Outcome

2021 ◽  
Author(s):  
Maria Witte ◽  
Johannes Reiner ◽  
Karen Bannert ◽  
Robert Jaster ◽  
Christian Maschmeier ◽  
...  
Keyword(s):  
Gene Expression ◽  
Crohn Disease ◽  
Transforming Growth Factor ◽  
Bowel Resection ◽  
Anastomotic Healing ◽  
Matrix Metalloproteinase 2 ◽  
Ileocecal Resection ◽  
Bursting Pressure ◽  
Septic Complications ◽  
Gelatinase Activity

Abstract Background Nucleotide-binding oligomerization domain-containing protein 2 (NOD2) mutations are a genetic risk factor for Crohn disease. Ileocecal resection is the most often performed surgery in Crohn disease. We investigated the effect of Nod2 knockout (KO) status on anastomotic healing after extended ileocecal resection (ICR) in mice. Methods Male C57BL6/J wild-type and Nod2 KO mice underwent an 11 cm resection of the terminal ileum including the cecum. An end-to-end jejuno-colostomy was performed. Animals were killed after 5 days investigating bursting pressure, hydroxyproline content, and expression of matrix metabolism genes, key cytokines, and histology of the anastomosis. Results Mortality was higher in the Nod2 KO group but not because of local or septic complications. Bursting pressure was significantly reduced in the Nod2 KO mice (32.5 vs 78.0 mmHg, P < 0.0024), whereas hydroxyprolin content was equal. The amount of granulation tissue at the anastomosis was similar but more unstructured in the Nod2 KO mice. Gene expression measured by real-time polymerase chain reaction showed significantly increased expression for Collagen 1alpha and for collagen degradation as measured by matrix metalloproteinase-2, -9, and -13 in the Nod2 KO mice. Gelatinase activity from anastomotic tissue was enhanced by Nod2 status. Gene expression of arginase I, tumor necrosis factor-α, and transforming growth factor-ß but not inducible nitric oxide synthase were also increased at the anastomosis in the Nod2 KO mice compared with the control mice. Conclusions We found that Nod2 deficiency results in significantly reduced bursting pressure after ileocecal resection. This effect is mediated via an increased matrix turnover. Patients with genetic NOD2 variations may be prone to anastomotic failure after bowel resection.

The Effects of Systemic Hypoxia on Colon Anastomotic Healing: An Animal Model

2005 ◽  
Vol 48 (7) ◽  
pp. 1460-1470 ◽  
Author(s):  
Jo-Anne P. Attard ◽  
Manoj J. Raval ◽  
Gary R. Martin ◽  
Jon Kolb ◽  
Marjan Afrouzian ◽  
...  
Keyword(s):  
Animal Model ◽  
Anastomotic Healing ◽  
Systemic Hypoxia

Reduction of Oxygenation and Blood Flow in Pedicled Bowel Segments in the Rat and Its Consequences for Anastomotic Healing

2010 ◽  
Vol 53 (1) ◽  
pp. 93-100 ◽  
Author(s):  
Lisanne A. E. Posma ◽  
Thijs Hendriks ◽  
Albert A. J. Verhofstad ◽  
Ben M. de Man ◽  
Roger M. L. M. Lomme ◽  
...  
Keyword(s):  
Blood Flow ◽  
Anastomotic Healing ◽  
Bowel Segments

Obsidian ASG® Autologous Platelet-Rich Fibrin Matrix and Colorectal Anastomotic Healing: A Preliminary Study

2021 ◽  
Vol 39 ◽  
Author(s):  
Andreas Shamiyeh ◽  
◽  
Bettina Klugsberger ◽  
Carina Aigner ◽  
Wolfgang Schimetta ◽  
...  
Keyword(s):  
Anastomotic Leakage ◽  
Anastomotic Leak ◽  
Colorectal Resection ◽  
Rectal Resection ◽  
Leak Rate ◽  
Anastomotic Healing ◽  
Platelet Rich Fibrin ◽  
Anastomotic Leak Rate ◽  
Fibrin Matrix ◽  
Autologous Platelet

Introduction: Anastomotic leakage (AL) following colorectal resection is a devastating complication affecting morbidity, mortality, and quality of life of patients in the long term. Different tissue sealants and biologic glues were tested showing conflicting results regarding their influence on anastomotic healing and leak prevention. Application of autologous platelet-rich fibrin (Vivostat A/S, Alleroed, Denmark), which acts as a source of angiogenic growth factors and cytokines, showed promising results in an in-vivo porcine model. Herein, we present the first human study of stapled colorectal anastomoses supplemented with an autologous-derived platelet-rich fibrin matrix (Obsidian ASG®, Rivolution GmbH, Rosenheim, Germany and Vivostat A/S, Alleroed, Denmark). Materials and Methods: A retrospective analysis of prospectively accumulated data was performed in two colorectal centers (Linz, Vienna) on patients undergoing left-sided colorectal or coloanal stapled anastomosis between October 2018 and December 2019. The Obsidian ASG® Matrix was applied to the rectal stump, and after closure with the circular stapling device, at the circumference of anastomosis in every single case. Anastomoses were supplemented with intra- and extra-anastomotic application (IAA—intra-anastomotic application developed by Rivolution GmbH, Rosenheim, Germany) of Obsidian ASG® Matrix. The primary endpoints were incidence of perioperative complications and anastomotic leak rate. Results: Two-hundred-sixty-one (138 female) patients underwent left-sided colonic (n=177) or rectal resection (n=84). In 253 (96.9%) cases, a laparoscopic or robotic-assisted approach was used. There were no complications attributable to the intraoperative application of the Obsidian ASG® Matrix. All intraoperative leak tests were negative. Overall, anastomotic leak rate accounted for 2.3% (6/261). AL following colonic and rectal resection was seen in 2.3% (4/177) and 2.4% (2/84), respectively. Complication and leak rate was similar in the two participating centers. Postoperative fever and elevated CRP levels were significantly correlated to AL. There was no significant risk factor for AL on multivariate analysis. Conclusion: Application of an autologous-derived platelet-rich fibrin matrix (Obsidian ASG®) at anastomotic site following colorectal resection is safe and associated with a low rate of anastomotic leakage.

scholarly journals Effect of Postoperative Diclofenac on Anastomotic Strength and Histologic Healing in Rabbit Small Intestine

2015 ◽  
Vol 100 (11-12) ◽  
pp. 1435-1442
Author(s):  
Sebastian S Le Grevès ◽  
Petter Lysberg Bremseth ◽  
Matteo Biagini ◽  
Rene Holst ◽  
Niels Qvist
Keyword(s):  
Placebo Group ◽  
Anastomotic Leakage ◽  
Breaking Strength ◽  
Gastrointestinal Surgery ◽  
Isotonic Saline ◽  
Anastomotic Healing ◽  
Postoperative Treatment ◽  
White Female ◽  
Negative Effects ◽  
Negative Effect

In this experimental study, we investigated the effects of a 5-day postoperative treatment with the nonsteroidal anti-inflammatory drug (NSAID) diclofenac on anastomotic healing in rabbits. NSAIDs are widely used analgesics in today's “fast-track surgery,” raising concerns about their potential negative effects on healing in humans. A total of 33 New Zealand White female rabbits underwent laparotomy and 2 separate end-to-end anastomoses of the ileum.. The animals were randomized to receive subcutaneous diclofenac 4 mg/kg/d (17 experimental rabbits) or subcutaneous isotonic saline 0.1 mL/kg/d (16 control rabbits) postoperatively. On the fifth postoperative day, the animals were humanely killed, and anastomotic leakage, anastomotic breaking strength, and histopathologic changes were evaluated. Breaking strength in the diclofenac group was 21% lower than in the placebo group (P = 0.027). Anastomotic leakage was found in 4 rabbits in the diclofenac group (26.7%). The rabbits treated with diclofenac demonstrated a 16% lower collagen deposition compared with the placebo group (P = 0.008). In our study, postoperative treatment with diclofenac had a negative effect on the anastomotic healing and strength in the ileum of rabbits. Caution should be taken in the use of diclofenac after gastrointestinal surgery.

Effects of Intraperitoneal Chemotherapy and GM-CSF on Anastomotic Healing: An Experimental Study in Rats

2002 ◽  
Vol 108 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Erhan Erdem ◽  
Soykan Dinç ◽  
Deniz Erdem ◽  
Hüseyin Üstün ◽  
Muzaffer Çaydere ◽  
...  
Keyword(s):  
Experimental Study ◽  
Intraperitoneal Chemotherapy ◽  
Anastomotic Healing ◽  
Gm Csf

The effect of tadalafil on anastomotic healing in ischemic small intestine in rats

Surgery Today ◽  
2010 ◽  
Vol 40 (6) ◽  
pp. 555-560 ◽  
Author(s):  
Yavuz Kaya ◽  
Teoman Coskun ◽  
Semin Ayhan ◽  
Eray Kara ◽  
Aslan Sakarya ◽  
...  
Keyword(s):  
Small Intestine ◽  
Anastomotic Healing
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