The effect of three different surgical techniques for colon anastomosis on regional postoperative microperfusion: Laser Doppler Flowmetry study in pigs

Article type: Research Article

Authors: Kaska, Milan^{a; *} | Blazej, Slavomir^a | Turek, Zdenek^b | Ryska, Ales^c | Jegorov, Boris^a | Radochova, Vera^d | Bezouska, Jan^a | Paral, Jiri^{a; d}

Affiliations: [a] Academic Department of Surgery, Medical Faculty, Charles University and Teaching Hospital, Hradec Kralove, Czech Republic | [b] Department of Anaesthesiology and Intensive Care Medicine, Medical Faculty, Charles University and Teaching Hospital, Hradec Kralove, Czech Republic | [c] Fingerland Department of Pathology, Medical Faculty, Charles University and Teaching Hospital, Hradec Kralove, Czech Republic | [d] Academic Department of Military Surgery, University of Defence, Hradec Kralove, Czech Republic

Correspondence: [*] Corresponding author: Milan Kaška, Academic Department of Surgery, Medical Faculty, Charles University and Teaching Hospital, Hradec Kralove, Simkova 870, 500 03 Hradec Kralove, Czech Republic. Tel.: +420 495833582; Fax: +420 495832108; E-mail: kaskam@lfhk.cuni.cz.

Abstract: BACKGROUND:The optimal surgical approach to reconnecting bowel ends safely after resection is of great importance. OBJECTIVES:This project is focused on assessment of the perianastomotic microcirculation quality in the short postoperative period when using three different anastomosis techniques in experimental animal. METHODS:The experimental study involved 27 young female domestic pigs divided into three subgroups of 9 animals according to each surgical method of anastomosis construction in the sigmoid colon region: by manual suture, by stapler, or by gluing. Blood microcirculation in the anastomosis region was monitored using Laser Doppler Flowmetry (LDF). Anastomosis healing was evaluated by macroscopic and histological examination. RESULTS:Evaluation of the microcirculation in the anastomosis region showed the smallest decrease in perfusion values in animals reconstructed by suturing (Δ= –38.01%). A significantly more profound drop was observed postoperatively after stapling or gluing (Δ= –52.42% and Δ= –59.53%, respectively). All performed anastomoses healed without any signs of tissue and function pathology. CONCLUSIONS:Sewing, stapling, and gluing techniques for bowel anastomosis each have a different effect on regional microcirculation during 120 min. postoperatively. Nevertheless, the final results of anastomosis healing were found without of any pathology in all experimental animals managed by above mentioned anastomotic techniques.

Keywords: Microcirculation, bowel anastomosis, experimental surgery

DOI: 10.3233/CH-170297

Journal: Clinical Hemorheology and Microcirculation, vol. 68, no. 1, pp. 61-70, 2018