Incorporating a poly-ε-caprolactone scaffold in a stapled small intestinal anastomosis with induced ischemia significantly increased anastomotic tensile strength. An experimental study in pigs.
| Autor: | Rimereit JE; Research Unit for Surgery, Odense University Hospital, Odense, Denmark.; University of Southern Denmark, Odense, Denmark., Lindgren CGW; Research Unit for Surgery, Odense University Hospital, Odense, Denmark.; University of Southern Denmark, Odense, Denmark., Nerup N; Department of Surgical Gastroenterology, Copenhagen University Hospital, Copenhagen, Denmark., Madsen GI; University of Southern Denmark, Odense, Denmark.; Research Unit for Pathology, Odense University Hospital, Odense, Denmark., Le DQS; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark., Möller S; Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Qvist N; Research Unit for Surgery, Odense University Hospital, Odense, Denmark.; University of Southern Denmark, Odense, Denmark., Ellebaek MB; Research Unit for Surgery, Odense University Hospital, Odense, Denmark. |
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| Jazyk: | angličtina |
| Zdroj: | Scandinavian journal of gastroenterology [Scand J Gastroenterol] 2024 Dec 05, pp. 1-8. Date of Electronic Publication: 2024 Dec 05. |
| DOI: | 10.1080/00365521.2024.2433541 |
| Abstrakt: | Objective: Anastomotic leakage is a severe complication with multifactorial aetiology, including impaired tissue oxygenation, infection, inflammation, and anastomotic tension. Reinforcement with poly-ε-caprolactone (PCL) scaffold incorporated in a stapled intestinal anastomosis has demonstrated a significant increase in the anastomotic tensile strength. This study aimed to investigate whether incorporation of the scaffold would influence tensile strength with induced ischemia compared to normal blood perfusion. Methods: Eighteen pigs were randomly allocated into an intervention group with a induced relative reduction in blood perfusion to 30% at the anastomotic area and a control group with normal perfusion controlled by quantitative fluorescence angiography. Each pig recieved two stapled small intestinal anastomoses, one with a PCL scaffold incorporated and one without. On postoperative day five, the anastomoses were subjected to a maximal tensile strength test (MATS) and a histopathological analysis. Tensile strength was measured at three events: when a serosal tear became visible (MATS-1), at transmural rupture (MATS-2), and at maximum load before the load-strain curve dropped (MATS-3). Results: In the intervention group, MATS-1 was significantly higher in scaffold-reinforced anastomoses compared to controls (7.9 ± 4.2N and 4.4 ± 2.5N, p < 0.02). The same tendency was found for MATS-2 and MATS-3, with statistically significant differences after adjusting for adhesion grade ( p < 0.05). Histological analysis revealed no significant differences in wound healing between groups. Conclusion: Incorporating a PCL scaffold in a stapled small intestinal anastomosis with induced ischemia improved anastomotic tensile strength. |
| Databáze: | MEDLINE |
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