K D Larsen1, M Westerholt1, G I Madsen2, D Q S Le3, Niels Qvist4,5, M B Ellebæk1. 1. Research Unit for Surgery, Odense University Hospital, University of Southern Denmark, Odense, Denmark. 2. Research Unit for Pathology, Odense University Hospital, University of Southern Denmark, Odense, Denmark. 3. Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200, Aarhus, Denmark. 4. Research Unit for Surgery, Odense University Hospital, University of Southern Denmark, Odense, Denmark. famqvist@dadlnet.dk. 5. Danish Centre for Regenerative Medicine (CRM), Odense University Hospital, J.B. Winsløwsvej 4, 5000, Odense, Denmark. famqvist@dadlnet.dk.
Abstract
BACKGROUND:Anastomotic leakage is a severe complication in gastrointestinal surgery. Different methods have been evaluated for anastomotic reinforcement to prevent anastomotic leakage. The aim of this study was to investigate the effect of a poly-ε-caprolactone (PCL) scaffold incorporated in the staple-line, on the anastomotic strength and histological wound healing, of small intestinal anastomoses in piglets. METHOD: This randomized experimental trial included 17 piglets. In each piglet, three end-to-end anastomoses were performed in the small intestine with a circular stapler, i.e. one control and two interventional anastomoses. On postoperative day 5, the anastomoses were resected and subjected to tension stretch test and histological examination. RESULTS: No anastomotic leakage occurred. In the interventional anastomoses, the mean value for maximal tensile strength was 15.7 N, which was significantly higher than control anastomoses 12.7 N (p = 0.01). No statistically significant differences were found between the two groups in the histopathological parameters. CONCLUSION: To conclude, this study has shown that the incorporation of a PCL scaffold in the staple-line was feasible and significantly increased the maximal tensile strength of small intestine anastomoses in piglets on postoperative day 5. The difference in histological parameters was not significantly distinct.
RCT Entities:
BACKGROUND: Anastomotic leakage is a severe complication in gastrointestinal surgery. Different methods have been evaluated for anastomotic reinforcement to prevent anastomotic leakage. The aim of this study was to investigate the effect of a poly-ε-caprolactone (PCL) scaffold incorporated in the staple-line, on the anastomotic strength and histological wound healing, of small intestinal anastomoses in piglets. METHOD: This randomized experimental trial included 17 piglets. In each piglet, three end-to-end anastomoses were performed in the small intestine with a circular stapler, i.e. one control and two interventional anastomoses. On postoperative day 5, the anastomoses were resected and subjected to tension stretch test and histological examination. RESULTS: No anastomotic leakage occurred. In the interventional anastomoses, the mean value for maximal tensile strength was 15.7 N, which was significantly higher than control anastomoses 12.7 N (p = 0.01). No statistically significant differences were found between the two groups in the histopathological parameters. CONCLUSION: To conclude, this study has shown that the incorporation of a PCL scaffold in the staple-line was feasible and significantly increased the maximal tensile strength of small intestine anastomoses in piglets on postoperative day 5. The difference in histological parameters was not significantly distinct.
Authors: R Kube; P Mroczkowski; D Granowski; F Benedix; M Sahm; U Schmidt; I Gastinger; H Lippert Journal: Eur J Surg Oncol Date: 2009-09-22 Impact factor: 4.424
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