Experimental evaluation of a bovine pericardium-derived collagen matrix buttress in ileocolic and colon anastomoses.

Autor: Gaertner WB; Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA. gaert015@umn.edu, Hagerman GF, Potter MJ, Karulf RE
Jazyk: angličtina
Zdroj: Journal of biomedical materials research. Part B, Applied biomaterials [J Biomed Mater Res B Appl Biomater] 2010 Jan; Vol. 92 (1), pp. 48-54.
DOI: 10.1002/jbm.b.31488
Abstrakt: Background: Anastomotic leakage is a major complication of colorectal surgery. The purpose of this study was to evaluate and compare stapled ileocolic and colon-colon anastomoses with or without a collagen buttress derived from bovine pericardium in the immediate postoperative period.
Methods: Various stapling devices were used to create ileocolic and colon-colon anastomoses in a canine model. Ileocolic anastomoses were created by simulating two different techniques: "open" and "laparoscopic". Colon-colon anastomoses were created by using a double-stapled technique. A total of 27 colon anastomoses (13 left colon-colon, 8 right "laparoscopic", and 6 right "open") were created. Anastomoses buttressed with bovine pericardium (n = 15) were compared to anastomoses without any reinforcement (n = 12). Staple lines were evaluated 4 hours after operation. Evaluation included bursting pressure and bursting location.
Results: No stapler device malfunction occurred. Excision rings were complete in all colon-colon anastomoses. All non-buttressed anastomoses burst at the staple line, whereas with buttressed anastomoses the adjacent intestine burst (p = 0.0001). The intestinal bursting pressure of bowel segments with buttressed staple lines (mean, 362 mmHg) was significantly higher than the bursting pressure of non-buttressed staple lines (mean, 204 mmHg, p < 0.0001).
Conclusion: The use of a collagen matrix buttress derived from bovine pericardium in stapled ileocolic and colon-colon anastomoses was safe. Buttressed anastomoses showed greater bursting strength as compared to non-buttressed anastomoses in the immediate postoperative period in a canine model.
((c) 2009 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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