Studies in intestinal healing VI. Effect of pharmacologically induced peristalsis on fresh intestinal anastomoses in dogs.

This study was devised to disclose any harmful effect of stimulation of the bowel by neostigmine (Prostigmin), alone, or in combination with castor oil in 220 canine anastomoses (60 stapled, 60 two-layer silk and catgut inverted, and 100 one-layer silk everted) performed in enteroenterostomies, ileocolostomies, and colocolostomies. Two techniques were used for the one-layer everted anastomoses--a through-and-through simple interrupted ("Navy") and a horizontal mattress interrupted. One hundred and ten experimental dogs received neostigmine intramuscularly on each of the first three postoperative days. Forty-five of these dogs also received castor oil orally on the first two postoperative days. Peristalsis induced by neostigmine, alone or in combination with castor oil, has no deleterious effect on stapled or conventional two-layer inverted or one-layer Navy everted anastomoses of small bowel or colon, but adversely affects the one-layer "mattress" closure in the colon. Dogs with induced peristalsis had their first evacuation sooner and ate sooner.