Objective: Colonic
anastomotic leakage represents a complication with high mortality and
morbidity. In the present study, it was aimed to examine the effect of the amniotic
membrane on the healing of ischemic
colonic anastomosis.
Methods: 25
pregnant Wistar albino rats aged 19-21 days were randomly divided into 5
groups. With midline laparotomy, pregnancies were terminated, and fresh amniotic membranes were obtained. In Group
1 Sham (S), no procedure except for laparotomy was performed. In Group 2 of colonic
anastomosis (A), the descending colon was completely transected and
anastomosed. In Group 3 of amniotic anastomosis (AA), the anastomosis line was
fixed by being wrapped with the fresh amniotic membrane. In Group
4 of colonic ischemic anastomosis (IA), the marginal arteries were ligated
after descending colon transection.
Ischemia was induced, and anastomosis was performed. In Group 5 of colonic ischemic anastomosis wrapped with the amniotic
membrane (AIA), after ischemic colonic anastomosis was performed, the
anastomosis line was fixed by being wrapped with the amniotic membrane. On the
postoperative 7th day, rats were sacrificed, and
their anastomotic bursting pressures were measured. For histological examination,
the colon segment containing the anastomosis line was removed. Hematoxylin-eosin and Van Gieson trichrome
stained specimens were histologically evaluated and scored according to the Ehrlich-Hunt
model.
Results: Anastomotic
bursting pressures were measured in group S as the highest, in AA, AIA, A in a decreasing order and in group IA as the
lowest. The difference between groups S and AA was statistically insignificant
in the paired comparison of groups according to their bursting pressure values
(p=0.222). When the other pairs were compared, the difference between the
groups was calculated as significant (p< 0.05). According to the
Ehrlich-Hunt model, the total score was the highest in AIA group, decreased in
AA, IA, A groups in a decreasing order,
and was the lowest in group S. A paired comparison for total scores between the
groups was statistically insignificant between groups S and A (p=0.222). Other
paired comparisons were statistically significant (p< 0.05).
Conclusion: Wrapping
the colon anastomosis line with the amniotic membrane gave positive results
both in the ischemic colon as well as in the non-ischemic colon in terms of
bursting pressure and histological anastomosis safety.
Birincil Dil | İngilizce |
---|---|
Konular | Sağlık Kurumları Yönetimi |
Bölüm | Cerrahi Tıp Bilimleri Araştırma Yazıları |
Yazarlar | |
Yayımlanma Tarihi | 30 Eylül 2018 |
Kabul Tarihi | 18 Eylül 2018 |
Yayımlandığı Sayı | Yıl 2018Cilt: 40 Sayı: 3 |