Research Articles (Published online: 15-12-2021)
Primary Anostomosis versus Diverting Colostomy an Experimental study in Rats
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Abstract
ABSTRACT
Anastomotic dehiscence, following colorectal surgery is a significant cause of morbidity and mortality and is responsible for one-third of deaths following colorectal surgery. Primary repair in a contaminated field was thought to be associated with leakage from bowel anastomosis but peritoneal contamination did not have any effect on hydroxyproline levels or the tensile strength of primary anastomosis in either the large or small bowel 4 days after surgery. In the present study we are aiming to assess the value of the covering colostomy. All surgical maneuvers were conducted in the special laboratory of department of surgery, faculty of veterinary medicine, Suez-Canal University, Egypt. 40 male Sprague-Dawley rats were used and divided into two groups. Surgical procedure in
Group A was done as end-to-end single layer extramucosal anastomotic construction. Colostomy fashioning was performed as a loop colostomy in Group B. Our data as regard to mortality rate, anastomotic failure and manometric study suggested that diverting colostomy had no beneficial effect on operative outcome than primary anastomosis and we concluded that primary anastomosis could be performed in most left colonic anastomosis with satisfying results.
INTRODUCTION
Anastomotic dehiscence, following
colorectal surgery is a significant cause of morbidity
and mortality and at least one-third of deaths were
attributed to anastomotic leakage (Egger et al,
2001). Healing of intestinal anastomoses and in
particular the development of early postoperative
anastomotic strength may be compromised by
numerous technical, local and systemic factors
(Ender , et al.2001). Primary repair in a contaminated
field was thought to be associated with leakage from
bowel anastomosis. For this reason, major surgical
textbooks have stated that primary repair has a very
limited or no role in the face of peritoneal
contamination (Makela, et al .2003) . Novel findings
suggest that a diverting colostomy may increase
intestinal leakage after anastomosis formation in the
rat colon. Thus, the role of proximal colostomy in the
protection of colo rectal anastomosis needs to be
reevaluated and further investigations are required to
resolve the influence of surgical defunctioning on
intestinal healing (Mansson et al.2000) .To investigate the appropriate surgical method that
should be selected in the localized fecal peritonitis due
to colonic injuries, colonic injuries were performed in
rats and the repairs were carried out after 24 hours. If the
injured or perforated colon is surrounded by the organs
and so the generalized peritonitis is avoided, primary
anastomosis would have similar results with colostomy
despite fecal contamination and prolonged intervention
time (Kayaalp, et al.2003). In the present study, the
author is aiming to assess the value of the covering
colostomy.
MATERIALS AND METHODS
In the present study male Sprague Dawley rats were used and housed five animals to a cage with the appropriate diet and water provided ad libitum Rats were observed for several days to ascertain health before operations and divided in to two groups for study.[rats for each].
All surgical maneuvers were conducted in the special laboratory of Department of Surgery & Anaesthiology in the Faculty of Veterinary Medicine,Suez-Canal University, Egypt. Male rats having an average weight 250-300 grams of Sprague-Dawley species, obtained from the documented animal house of the Faculty of Veterinary Medicine,, Suez-Canal University.
Local ethics committee for the use of laboratory animals approved all experimental procedures.Appropriate animal care and use were performed according to implementation and compliance with the Animal Welfare Act
MATERIALS AND METHODS
In the present study male Sprague Dawley rats were used and housed five animals to a cage with the appropriate diet and water provided ad libitum Rats were observed for several days to ascertain health before operations and divided in to two groups for study.[rats for each].
An intra operative photograph showing the start and the finish of Anastomosis.
All surgical maneuvers were conducted in the special laboratory of Department of Surgery & Anaesthiology in the Faculty of Veterinary Medicine,Suez-Canal University, Egypt. Male rats having an average weight 250-300 grams of Sprague-Dawley species, obtained from the documented animal house of the Faculty of Veterinary Medicine,, Suez-Canal University.
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Article history: Received: 15-12-2021, Accepted : 15-12-2021, Published online: 15-12-2021
